Hemorrhagic stroke due to cerebellar arteriovenous malformation managed in a Medium-Complexity Public Hospital: a case report

Cerebellar Arteriovenous Malformations (CMAVs) are rare but clinically significant vascular anomalies with a high risk of hemorrhage. We report a case of a 51-year-old hypertensive male who presented with a thunderclap headache and cerebellar hemorrhage due to an arteriovenous cerebellar malformation. Initial CT revealed two intraparenchymal hemorrhages in the left cerebellar hemisphere with mild mass effect. Angio tomography and MRI confirmed the vascular anomaly. The patient underwent neurocritical care with blood pressure control and showed partial neurological recovery, with residual gait ataxia, horizontal nystagmus, and a positive Romberg sign. This case underscores the importance of considering CMAVs in spontaneous cerebellar hemorrhages. Even in medium-complexity public hospitals, timely neurocritical care and diagnostic imaging can stabilize patients, allowing for appropriate referral to specialized care.