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Discussion:

Spontaneous SDH is very rare, and there are some hypotheses about the reasons for its occurrence. First, brain movement stretches the arachnoid layer that adheres to the AVM, resulting in direct bleeding into subdural space. Second, high-flow pia-arachnoid ruptured blood might extravasate into subdural space. Finally, the ruptured cortical artery that connects the cortex and dura layer (bridging artery) might also cause SDH. Some scoring systems are useful in BAVM, and this study selected endovascular embolization for the patient.

Conclusion:

Brain AVM rupture usually causes ICH, SAH, or IVH. Clinicians must be more aware of spontaneous SDH because it might be caused by a vascular malformation, although it is rare.