title: Spontaneous regression of brain arteriovenous malformations--a clinical study and a systematic review of the literature.
abstract: 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.
authors.affiliation: Dept. of Neurosurgery, VU University Medical Center, 2D 168, P. O. Box 7057, 1007, MB Amsterdam, The Netherlands. dr.buis@vumc.nl
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Buis
authors.forename: René
authors.initials: R
authors.lastname: van den Berg
authors.forename: Geert
authors.initials: G
authors.lastname: Lycklama
authors.forename: H Bart
authors.initials: HB
authors.lastname: van der Worp
authors.forename: Clemens M F
authors.initials: CM
authors.lastname: Dirven
authors.forename: W Peter
authors.initials: WP
authors.lastname: Vandertop
mesh_terms: 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