'Salt and pepper on the face' pain followed by cardiac and respiratory arrests. The stormy postoperative manifestations after the surgery of posterior fossa arteriovenous malformation.

The authors describe 'salt and pepper on the face' pain in a case of medullary arteriovenous malformation (AVM), which was caused by post-operative hemorrhage from a very small residual nidus of AVM left remaining in the left dorsal medulla. The peculiar, sharp, jabbing pain, which has been rarely reported at the onset of intracranial hemorrhage, was followed by acute elevation of blood pressure, arrhythmia, cardiac and respiratory arrests. The patient had been in a comatose state for a month and gradually recovered from the cardiopulmonary and neurological derangements. The pathophysiology of the phenomenon which occurred in this case is discussed.