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Introduction: Brain Arteriovenous Malformation (BAVM) is a rare disease with an incidence rate of 1.3 out of 100,000 people. The most common clinical manifestations in BAVM patients are intracranial hemorrhage. There were 38.5% of BAVM patients who had intraventricular hemorrhage (IVH), and the rate of IVH without parenchymal bleeding in the ruptured AVM is 7.8%. We reported a case of BAVM with intraventricular hemorrhage presentation without intracerebral hemorrhage (isolated IVH). Case: Male, 15 years old, with a chief complaint of acute decreased consciousness on activity, followed by vomiting and general onset seizures. There was no history of hypertension or trauma before. From the neurological examination, the GCS is 225, and there were positive pathological reflexes on both sides. From a head CT scan without contrast, we found IVH in bilateral lateral ventricles, ventricle III and ventricle IV, communicating hydrocephalus, and brain edema. Head and Neck Computed Tomography Angiography (CTA) found a compact AVM in the left centrum semiovale-cortex parietal (Spetzler Martin AVM grading system grade 3). Patients underwent EVD surgery for hydrocephalus. The following steps are cerebral DSA as the gold standard for AVM diagnostic and targeted embolization to prevent further bleeding. Conclusion: One of the causes of Isolated Intraventricular Hemorrhage (IIVH) is AVM. In this case, although the topography of AVM is in the gyral, it can cause IIVH manifestation if there is contact between the AVM nidus and the ventricle.

Case Report: Gyral Brain Arteriovenous Malformation with Presentation Isolated From Intraventricular Hemorrhage