Spontaneous Subarachnoid Hemorrhage from a Pure Pial Arterial Malformation in the Lateral Cerebellomedullary Junction: Clinical Images with Surgical Video

Abstract Pure Pial arterial malformations (PAM) are poorly understood due to the limited number of reported cases. Because PAMs are thought to have a benign natural history these are generally managed conservatively, unlike arterio-venous malformations or arterio-venous fistulae. In this case report we present a spontaneous subarachnoid hemorrhage from the rupture of a PAM at the cerebellomedullary junction. This hemorrhage was surgically treated by clip trapping.