In May 2017, a 34-year-old patient experienced a ruptured arteriovenous malformation (AVM) near their brain, which caused a stroke. Initially discharged from St Thomas' hospital with a theory of a bruised spine, a follow-up scan demanded by their partner, an ICU nurse, revealed a massive brain bleed.
Tests confirmed a Grade 4 AVM, typically considered too risky for removal. However, a consultant neurosurgeon decided to proceed with surgery due to the patient's age and the risk of another bleed.
The operation, involving three neurosurgeons and supporting teams, lasted over 16 hours. Towards the end of the procedure, a piece of the patient's skull was accidentally dropped. Concerns about infection led to the skull piece being cleaned and the patient receiving additional antibiotics.
The patient, who was in an induced coma, learned about the incident days later. Despite the setback, the surgery was successful in removing the AVM, which was found to be larger and more complex than initially thought. The consultant neurosurgeon now uses this case as evidence that larger AVMs can be successfully removed.