Spontaneous regression of intracranial arteriovenous malformations

Report of three cases

Restricted access

✓ This is a report of spontaneous regression of intracranial arteriovenous malformations (AVM's) in three female patients; two of these patients had complete angiographic disappearance of the AVM, including an instance of intimate association of the AVM with an astrocytoma. The AVM's in these two patients were unicompartmental medium- to large-sized lesions supplied by a single feeder and draining principally through one large vein; spontaneous thrombosis is suggested as a cause of the AVM regression. Partial regression in the third patient might have been partially due to embolism from a clot-filled aneurysm on the feeding vessel. The significance of such disappearance of AVM's in relation to persistence or otherwise of the neurological status of these patients is discussed.

Article Information

Present address for Dr. Omojola: Department of Radiology, Institute of Health Sciences, University of Port Harcourt, P.M.B. 5323, Port Harcourt Rivers State, Nigeria.

Address reprint requests to: Allan J. Fox, M.D., Department of Diagnostic Radiology, University Hospital, 339 Windermere Road, London, Ontario, Canada, N6A 5A5.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Right carotid angiograms, lateral views. Left: Initial appearance showing an arteriovenous malformation (AVM) supplied by a distal branch of the callosomarginal artery. Drainage is through a large vein into the superior sagittal sinus. Right: Angiogram 5 years later showing no trace of the AVM. The left carotid and left vertebral angiograms were normal.

  • View in gallery

    Left carotid angiograms, anteroposterior and lateral views. Upper: Initial appearance showing a medial temporal arteriovenous malformation (AVM, arrow) supplied by the anterior choroidal artery. Drainage is through a basal vein into the vein of Galen. Note the slight elevation of the Sylvian triangle. Lower: Repeat study, 3 years later, showing no trace of the AVM. The upward displacement of the Sylvian triangle is better appreciated in the absence of the AVM.

  • View in gallery

    Enhanced computerized tomography scan showing an enhancing tumor nodule within a cystic low-density area.

  • View in gallery

    Upper and center: Left vertebral angiograms, anteroposterior and lateral views. Upper: Initial appearance showing an enlarged right posterior cerebral artery feeding a right occipital arteriovenous malformation (AVM). Drainage is via a large vein directed toward the superior sagittal sinus. The aneurysm (arrow) is seen at the origin of the posterior cerebral artery (PCA). Center: Repeat study, 17 months later, showing diminution in caliber of the right PCA and delayed opacification of the AVM. Note the decrease in size and change in outline of the aneurysm. Stenoses (arrows) of the feeding artery have developed. The draining vein is not apparent. Lower: Computerized tomography scan showing punctate calcifications on the precontrast study (left). The AVM enhances following administration of contrast material (right). A low-density swelling of deep white matter surrounds the lesion.

References

  • 1.

    Bailey OT: The vascular component of congenital malformations in the central nervous system. J Neuropathol Exp Neurol 20:1701841961Bailey OT: The vascular component of congenital malformations in the central nervous system. J Neuropathol Exp Neurol 20:170–184 1961

    • Search Google Scholar
    • Export Citation
  • 2.

    Conforti P: Spontaneous disappearance of cerebral arteriovenous angioma. Case report. J Neurosurg 34:4324341971Conforti P: Spontaneous disappearance of cerebral arteriovenous angioma. Case report. J Neurosurg 34:432–434 1971

    • Search Google Scholar
    • Export Citation
  • 3.

    Crowell RMDeGirolami USweet WH: Arteriovenous malformation and oligodendroglioma. Case report. J Neurosurg 43:1081111975Crowell RM DeGirolami U Sweet WH: Arteriovenous malformation and oligodendroglioma. Case report. J Neurosurg 43:108–111 1975

    • Search Google Scholar
    • Export Citation
  • 4.

    Fine RDPaterson AGaylor JB: Recurrent attacks of subarachnoid haemorrhage in presence of a cerebral angioma and an intraventricular oligodendroglioma. Scott Med J 5:3423461960Fine RD Paterson A Gaylor JB: Recurrent attacks of subarachnoid haemorrhage in presence of a cerebral angioma and an intraventricular oligodendroglioma. Scott Med J 5:342–346 1960

    • Search Google Scholar
    • Export Citation
  • 5.

    Hansen JHSogaard I: Spontaneous regression of an extra- and intracranial arteriovenous malformation. Case report. J Neurosurg 45:3383411976Hansen JH Sogaard I: Spontaneous regression of an extra- and intracranial arteriovenous malformation. Case report. J Neurosurg 45:338–341 1976

    • Search Google Scholar
    • Export Citation
  • 6.

    Heeres JGHerkster REMThomeer RAF: ??Een geval van spontane trombosering van een arterioveneuze misvorming van de hersenvaten, tien jaar na het manifest worden van de afwijking. Ned Tijdschr Geneeskd 120:57611976Heeres JG Herkster REM Thomeer RAF: Een geval van spontane trombosering van een arterioveneuze misvorming van de hersenvaten tien jaar na het manifest worden van de afwijking. Ned Tijdschr Geneeskd 120:57–61 1976

    • Search Google Scholar
    • Export Citation
  • 7.

    Heffner RRPorro RSDeck MDF: Benign astrocytoma associated with arteriovenous malformation. Case report. J Neurosurg 35:2292331971Heffner RR Porro RS Deck MDF: Benign astrocytoma associated with arteriovenous malformation. Case report. J Neurosurg 35:229–233 1971

    • Search Google Scholar
    • Export Citation
  • 8.

    Höök OJohansen C: Intracranial arteriovenous aneurysms. A follow-up study with particular attention to their growth. Arch Neurol Psychiatry 80:39541958Höök O Johansen C: Intracranial arteriovenous aneurysms. A follow-up study with particular attention to their growth. Arch Neurol Psychiatry 80:39–54 1958

    • Search Google Scholar
    • Export Citation
  • 9.

    Levine JMisko JCSeres JLet al: Spontaneous angiographic disappearance of a cerebral arteriovenous malformation. Third reported case. Arch Neurol 28:1951961973Levine J Misko JC Seres JL et al: Spontaneous angiographic disappearance of a cerebral arteriovenous malformation. Third reported case. Arch Neurol 28:195–196 1973

    • Search Google Scholar
    • Export Citation
  • 10.

    Norlén G: Arteriovenous aneurysms of the brain. Report of ten cases of total removal of the lesion. J Neurosurg 6:4754941949Norlén G: Arteriovenous aneurysms of the brain. Report of ten cases of total removal of the lesion. J Neurosurg 6:475–494 1949

    • Search Google Scholar
    • Export Citation
  • 11.

    Nukui HMiyagi OTamada Jet al: Long-term follow-up study by cerebral angiography in cases with arterio-venous malformation of the brain. Neurol Med Chir 22:1251321982Nukui H Miyagi O Tamada J et al: Long-term follow-up study by cerebral angiography in cases with arterio-venous malformation of the brain. Neurol Med Chir 22:125–132 1982

    • Search Google Scholar
    • Export Citation
  • 12.

    Parkinson DBachers G: Arteriovenous malformations. Summary of 100 consecutive supratentorial cases. J Neurosurg 53:2852991980Parkinson D Bachers G: Arteriovenous malformations. Summary of 100 consecutive supratentorial cases. J Neurosurg 53:285–299 1980

    • Search Google Scholar
    • Export Citation
  • 13.

    Paterson JHMcKissock W: A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 79:2332661956Paterson JH McKissock W: A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 79:233–266 1956

    • Search Google Scholar
    • Export Citation
  • 14.

    Sartor K: Zum Spontanverschluss arteriovenoser Misbildungen des Gehirns. Nervenarzt 49:34371978Sartor K: Zum Spontanverschluss arteriovenoser Misbildungen des Gehirns. Nervenarzt 49:34–37 1978

    • Search Google Scholar
    • Export Citation
  • 15.

    Sukoff MHBarth BMoran T: Spontaneous occlusion of a massive arteriovenous malformation. Case report. Neuroradiology 4:1211231972Sukoff MH Barth B Moran T: Spontaneous occlusion of a massive arteriovenous malformation. Case report. Neuroradiology 4:121–123 1972

    • Search Google Scholar
    • Export Citation
  • 16.

    Svien HJMcRae JA: Arteriovenous anomalies of the brain. Fate of patients not having definitive surgery. J Neurosurg 23:23281965Svien HJ McRae JA: Arteriovenous anomalies of the brain. Fate of patients not having definitive surgery. J Neurosurg 23:23–28 1965

    • Search Google Scholar
    • Export Citation
  • 17.

    Svien HJPeserico L: Regression in size of arteriovenous anomaly. J Neurosurg 17:4934961960Svien HJ Peserico L: Regression in size of arteriovenous anomaly. J Neurosurg 17:493–496 1960

    • Search Google Scholar
    • Export Citation
  • 18.

    Warren GC: Intracranial arteriovenous malformation, pulmonary arteriovenous fistula, and malignant glioma in the same patient. J Neurosurg 30:6186211969Warren GC: Intracranial arteriovenous malformation pulmonary arteriovenous fistula and malignant glioma in the same patient. J Neurosurg 30:618–621 1969

    • Search Google Scholar
    • Export Citation
  • 19.

    Welcker ERSeidel K: Kombination eines Angioma arteriovenosum aneurysmaticum mit einem Astrocytom. Dtsch Z Nervenheilk 189:2312391966Welcker ER Seidel K: Kombination eines Angioma arteriovenosum aneurysmaticum mit einem Astrocytom. Dtsch Z Nervenheilk 189:231–239 1966

    • Search Google Scholar
    • Export Citation

Cited By

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 68 68 6
Full Text Views 168 168 0
PDF Downloads 93 93 0
EPUB Downloads 0 0 0

PubMed

Google Scholar