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Spontaneous disappearance of intracranial arterio-venous malformations
Abstract:
4 cases of spontaneous disappearance of intracranial arteriovenous malformations are reported. All the malformations were in the rolandic-parietal area, and fed in most cases by the MCA. In one case, the malformation was associated with a proximal aneurysm. One malformation was large, one medium-sized, and two small. Venous drainage was towards the longitudinal sinus in all cases. Presenting symptoms consisted of epilepsy in 2 cases, and intracerebral haemorrhage in 2 cases. Disappearance of the AVM was documented by angiography from 1 to 15 years after diagnosis, and was preceded by a new haemorrhage in 2 cases. Acute or gradual thrombosis of the AVM is suggested as the most likely cause of the disappearance of an AVM. Spontaneous thrombosis of an AVM should be considered as an aspect of the pathological entity known as "thrombosed AVM". Guidelines for the management of patients exhibiting spontaneous disappearance of an AVM are briefly discussed.
Insights
Four cases of spontaneous intracranial arteriovenous malformations (AVMs) disappearing over time were documented. This phenomenon, likely due to AVM thrombosis, offers insights into AVM pathology and management.
Area of Science:
- Neurology
- Neuroradiology
- Vascular Neurology
Background:
- Intracranial arteriovenous malformations (AVMs) are complex vascular lesions.
- Spontaneous resolution of AVMs is a rare but recognized occurrence.
Observation:
- Four cases of spontaneous AVM disappearance were observed.
- AVMs were located in the rolandic-parietal region, often supplied by the middle cerebral artery (MCA).
- Symptoms included epilepsy and intracerebral hemorrhage; venous drainage was consistently towards the longitudinal sinus.
Findings:
- Angiographic evidence confirmed AVM disappearance 1-15 years post-diagnosis.
- Two cases experienced a new hemorrhage preceding AVM resolution.
- Acute or gradual thrombosis is the proposed mechanism for spontaneous AVM disappearance.
Implications:
- Spontaneous AVM thrombosis should be recognized as a distinct pathological entity.
- Understanding this process may inform management strategies for AVM patients.
- Further research into the mechanisms of AVM thrombosis is warranted.