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Lusy Eriyanti*, Syarif Indra**, Basjiruddin A***

*) Resident in Departement of Neurology, Andalas University / M. Djamil Hospital, Padang

**) Staff in Departement of Neurology, Andalas University / M. Djamil Hospital, Padang

***) Staff in Departement of Neurology, Andalas University / M. Djamil Hospital, Padang

ABSTRACK

Background: At a young age that could be the cause of intra-cerebral bleeding was non-
traumatic arterivena malformations and aneurysms congenital. Although the young age have a
lower risk of stroke incidence, but stroke in young age groups have a major impact in the
community. The incidence of stroke in young age groups and children is about 2 per 100
thousand children per year, with a prevalence rate of 18 per 100 thousand children. Arterivena
malformation is one of the causes of stroke in 2% cases of intra-cerebral hemorrhage, especially
a young age and 9% of cases of subaraknoid bleeding.

Case report: A boy aged 16 years of dating with a great headache complaints that happen
suddenly while on the move. From the history of the disease once patients had been treated at the
children in 2005 with a diagnosis of intra-cerebral hemorrhage. From the current physical
examination found signs meningeal stimulation stiff neck, a sign of positive kerniq without
neurological deficits. From the results of CT Brain Scan picture looks small lesions with
calcification hiperdens ventricular area 4, the results obtained pungsi lumbar fluid reddish color.
After an MRI examination images obtained serpigenous (honeycomb) with fluid flow and the
nidus in the posterior pons region. MRA looks at the picture of a. posterior cerebral serpigenous /
tortuous, with the nidus and venous drainage from the posterior vena sagitalis, and hiperdens
lesions on T1W and T2W in the intra ventricular posterior left lateral cornua. Patients do not
remember the location of surgery in the posterior part of the AVM, and were treated
conservatively for 3 weeks, came home with a recommendation not to do heavy physical
activity.

Conclusion: Arterivena malformation rupture in these patients is a cause of subaraknoid


hemorrhage. Surgery is still difficult to consider him AVM location. Limitation of physical
activity is one way to avoid re-bleeding.