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P395: SUPRACELLAR INFRATENTORIAL APPROACH FOR COMPLETE RESECTION OF RUPTURED VERMIAN AVM
Moleca Ghannam, MD, MPhil¹; Tina Wang, MA²; Timothy R Miller, MD²; Dheeraj Gandhi, MBBS²; Mohamed Labib, MD²; ¹University at Buffalo; ²University of Maryland School of Medicine

We present a female in her fifties who presented obtunded with posterior fossa hemorrhage from a ruptured vermian arteriovenous malformation (AVM) and perinidal aneurysm. Emergent suboccipital craniectomy achieved decompression and clot evacuation. Angiography revealed a vermian AVM supplied by PICA and SCA branches with a perinidal aneurysm, which was coiled. Definitive resection was performed via a supracerebellar infratentorial approach. Postoperative angiography confirmed cure, with the patient at GCS 11T at discharge and continuing to recover. 

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