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The purpose of this paper is to report our experience of treating cerebral arteriovenous malformations (AVM) in adults with pre-operative embolisation and microsurgical resection on the same day during a single anaesthetic at a single centre between April 2016 and December 2018. We included both elective AVM and AVM that had bled acutely.We retrospectively analysed data from patients with cerebral AVMs who underwent embolisation followed by microsurgical resection on the same day at a single neurosurgical centre.Total procedure time (embolisation and microsurgical resection), procedure finish time, intra-operative blood loss, degree of nidus obliteration on postoperative angiography, intensive care unit (ICU) stay, total stay at the neurosurgical centre and modified Rankin Score (pre- and post-procedure).•Nineteen patients underwent same-day pre-operative embolisation and microsurgical resection over the 32-month period. The average patient age was 40 years (range 19-66 years). One patient had undergone a prior attempt at embolisation and one patient previously had sterotactic radiosurgery (STRS). •Thirteen of the AVM were in the dominant hemisphere and six in the non-dominant hemisphere. Sixteen AVM were located supratentorially and three were in the posterior fossa. Spetzler-Martin grades included 4 grade 1, 10 grade 2, 4 grade 3 and 1 grade 4. •The average blood loss intra-operatively was 289 mls. •The average list finish time was 19:56 (range 15:10-00:00). •Seventeen patients had 100% nidus obliteration on post-operative digital subtraction angiography, one patient had a small remnant and was referred to STRS and one patient died in the ICU post operatively.Overall, the authors believe same-day embolisation and microsurgical resection represents a safe treatment strategy. The technique minimises hemorrhagic complications from delayed venous occlusion and avoids multiple anaesthetics and hospital admissions.

Purpose: Abducens schwannomas are rare tumors that are not known to present with acute haemorrhage. We present a case of a 59 year-old female on warfarin who presented acutely with a sudden onset headache, nausea and photophobia. Neuroimaging revealed an acute haemorrhage into a lesion that entered Dorello's canal and was consistent with an abducens nerve schwannoma.Materials and methods: The patient's case notes, imaging, histology and operative recording were reviewed retrospectively to compile this case report.Results: The tumor was resected via a retro-mastoid approach with sacrifice of the abducens nerve. Removal of the haematoma intra-operatively provided more space in the surgical corridor to facilitate resection. Final histological examination confirmed the diagnosis of schwannoma and the patient made a good post-operative recovery.Conclusion: We conclude that accurate pre-operative radiological diagnosis can facilitate surgical planning and removal of haematoma at an early stage during the operation can create space and facilitate resection. Furthermore, abducens schwannoma should be considered in the differential diagnosis of any heamorrhagic cerebello-pontine angle lesion.