Korean J Radiol.  2002 Mar;3(1):74-77. 10.3348/kjr.2002.3.1.74.

Spontaneous Partial Regression of Cerebral Arteriovenous Malformation

• Choi JH
• Shin JH
• Cho SS
• Choi DL
• Byun BJ
• Kim DW

• KMID: 1758450
• DOI: http://doi.org/10.3348/kjr.2002.3.1.74

Abstract

Arteriovenous malformation (AVM) of the brain is one of the important pathologic conditions which cause intracerebral or subarachnoid hemorrhage, epilepsy, or chronic cerebral ischemia. The spontaneous regression of cerebral AVM is reported to be very rare and more likely to occur when the AVM is small, is accompanied by hemorrhage, and has fewer arterial feeders. We report a case of right occipital AVM which at follow-up angiography performed four years later showed near-complete spontaneous regression.

Keyword

Brain, abnormalities; Brain, diseases; Cerebral blood vessels, abnormalities

MeSH Terms

Adult
Case Report
Cerebral Angiography
Human
Intracranial Arteriovenous Malformations/*radiography
Male
Remission, Spontaneous
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Initial radiologic studies of an AVM in a 41-year-old man with sudden onset of headache and blurred vision. A. Enhanced CT scan shows a large intracerebral hematoma (arrows) in the right occipital lobe. Clearly enhanced tubular structures (arrowheads) are seen in the medial occipital lobe adjacent to the hematoma. B. Axial gadolinium-enhanced T1-weighted MR image suggests that the hematoma i.e. is not certain; thus, 'suggests that is iso-intense, with a peripheral high-signal-intensity rim (arrows) secondary to the presence of methemoglobin'. The tubular structures representing the AVM are seen as signal voids (arrowheads). C. Early-phase left vertebral angiogram depicts an AVM supplied by the right posterior cerebral artery (arrow). D. Delayed-phase left vertebral angiogram shows an early-draining single vein (arrow) which drains into the right transverse sinus (arrowhead). Note the tortuous proximal portion of the early draining vein (curved arrow).

• 

  Fig. 2 Follow-up CT scan and angiogram four years later without further treatment. A. Enhanced CT scan reveals marked regression, with a small residual AVM in the right occipital lobe and some encephalomalatic change at the site of the previous hematoma. B. Right vertebral angiography shows complete disappearance of the AVM in the right occipital lobe. C. Early-phase angiogram of the right external carotid artery depicts a residual AVM supplied by the right middle meningeal artery (arrows). D. Late-phase angiogram of the right external carotid artery shows the same draining vein (arrow) seen at initial vertebral angiography, which drains into the right transverse sinus (arrowhead). The disappearance of the previous proximal portion of the draining vein seen in Fig. 1D suggests thrombus formation. E. Photomicrograph (hematoxylin-eosin stain; magnification ×100) depicts an AVM composed of abnormal vessels of various sizes and with fresh intraluminal thrombi (arrows).

Reference

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