Spontaneous regression of brain arteriovenous malformations--a clinical study and a systematic review of the literature.
OBJECTIVE
Complete spontaneous obliteration of a brain arteriovenous malformation (AVM) is a rare event, with 67 angiographically proven cases in the world literature. We present a new case and a systematic literature review to determine possible mechanisms underlying this unusual phenomenon.


METHODS
One patient with a brain AVM was referred for radiosurgical treatment. Shortly before treatment however, complete spontaneous regression occurred. This patient had experienced a hemorrhage in the months before referral.


RESULTS
We found 38 articles in which 67 cases of complete and spontaneous regression of a brain AVM were presented. Male to female ratio was 1.2, with a mean age of 37 years (range 1-81). Regression occurred in 72% without new neurological events. Median size of the nidus was 2 cm (range 1-7). There was a single arterial feeder in 46 % and a single draining vein in 59%.


CONCLUSIONS
Spontaneous regression of a brain AVM is the result of multiple interacting factors. Intracranial hemorrhage and the presence of a single draining vein seem to play a major role in this process.
Buis
Dennis R
DR
Dept. of Neurosurgery, VU University Medical Center, 2D 168, P. O. Box 7057, 1007, MB Amsterdam, The Netherlands. dr.buis@vumc.nl
van den Berg
René
R
Lycklama
Geert
G
van der Worp
H Bart
HB
Dirven
Clemens M F
CM
Vandertop
W Peter
WP
D006801:Humans; D008297:Male; D008875:Middle Aged; D002533:Cerebral Angiography / Q000379:methods; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016634:Radiosurgery / Q000379:methods; D012075:Remission, Spontaneous