Spontaneous subdural hemorrhage due to ruptured arteriovenous malformation in a child

Abstract

Spontaneous subdural hemorrhage (SDH) is an uncommon nontraumatic bleed of the brain, involving the dura and arachnoid mater. SDH commonly occurs due to tearing of bridging veins; however, SDH from the rupture of arteriovenous malformation (AVM) is an uncommon phenomenon, particularly in children. We report a case of atypical SDH in a 1-year-old child with AVM and a history of alleged abuse. Autopsy revealed SDH in the right parietal and middle cranial fossa without any external or internal injuries to the head, brain, or other parts of the body. Histopathological examination and immunohistochemical staining of the brain tissue revealed an abnormal distribution of arteries and veins of various sizes and architecture. From a detailed histopathological examination of the brain and meticulous investigation of vascular abnormalities, we conclude the cause of acute SDH to be due to a ruptured AVM.

Keywords

• Arteriovenous malformations
• child abuse
• spontaneous subdural hemorrhage