REPORT OF A PATIENT WITH ARTERIOVENOUS MALFORMATION ACCORDING TO TRANS CRANIAL DOPPLER (TCD) SONOGRAPHY AND IT'S CORRELATION WITH MAGNETIC RESONANCE ANGIOGRAPHY (MRA)

Arteriovenous Malformation(AVM) is one of the most common etiologies of subarachnoid hemorrhage. In the past, conventional angiography was the only way for the diagnosis of AVM but nowadays, using noninvasive devices such as MRA and recently TCD, the diagnosis of AVM is revaluated. This patient is a 19 year old man who was admitted for a severe headache and convulsion after its onset. Despite of overt signs of meningeal irritation, the axial brain CT scan was normal so lumbar puncture was performed and the diagnosis of subarachnoid hemorrhage was documented. First with the diagnosis of Aneurysmal subarachnoid hemorrhage, TCD sonography was done but surprisingly blood flow indices were indicating the presence of an AVM in the territory of right MCA and MRA established it. TCD not only can anticipate the risk of vasospasm in the patient with subarachnoid hemorrhage, but also it can reveal AVM as the second etiology of subarachnoid hemorrhage. So it is recommended that blood flow indices should be noticed in any patient with the diagnosis of subarachnoid hemorrhage for early recognition of AVM.