Complete regression of intracranial arteriovenous malformations. Surg Neurol 2002 Aug;58(2):139-47; discussion 147
Date
11/28/2002Pubmed ID
12453655DOI
10.1016/s0090-3019(02)00769-3Scopus ID
2-s2.0-0036703701 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
BACKGROUND: Spontaneous and complete regression of intracranial arteriovenous malformations (AVMs) is a rare occurrence, with only 59 angiographically proven cases reported in the English literature. We present three new cases and perform a literature review to determine possible mechanisms underlying this unusual phenomenon.
METHODS: Three patients with angiographically proven AVMs demonstrated complete obliteration of the AVM on follow-up angiography. Two patients had MRIs performed at the time of follow-up angiography.
RESULTS: A literature review of all reported cases shows that the vast majority (88%) of spontaneously closing AVMs had a single draining vein as did our three cases. In addition, hemodynamic alterations of intracranial (IC) blood flow, including intracranial hemorrhage, were seen in a majority (79%) of patients, including two of our three cases. MRI was performed in two of our three cases and showed a thrombosed-draining vein in both.
CONCLUSIONS: Complete spontaneous regression of intracranial AVMs is a rare occurrence. The phenomenon seems to require the interaction of hemodynamic changes in compromising or closing the limited, usually single, venous drainage pathway from the AVM. Hemorrhage may contribute to the effect by further compromising flow though the lesion, or it may merely be a phenomenon associated with the effects of venous hypertension on the AVM nidus.
Author List
Schwartz ED, Hurst RW, Sinson G, Bagley LJAuthor
Grant P. Sinson MD Associate Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Cerebral Angiography
Humans
Intracranial Arteriovenous Malformations
Male
Remission, Spontaneous