Progressive spontaneous occlusion of a cerebellar AVM: pathogenetic hypothesis and review of literature.
Cerebral arteriovenous malformation (AVM) is a complex network of vascular channels consisting of arterial feeders, a nidus and enlarged venous drainage. AVMs usually increase in size with time, but may rarely obliterate; spontaneous angiographic regression occurs in less than 1.5% of cerebral AVMs. Several causes of spontaneous regression have been postulated such us hemodynamic alterations due to hemorrhage, hypercoagulability, atherosclerosis, and tromboembolism from associated aneurysms. In this report we describe a case of spontaneous, complete and asymptomatic occlusion of a left cerebellar hemispheric AVM; angiograms clearly demonstrate a progressive decrease in size of the AVM at follow-up. Thrombosis of the dominant-draining vein caused by turbulent blood flow seemed to be the main driver. Possible mechanisms leading to the occlusion are discussed and a review of the literature is reported.
Panciani
P P
PP
Department of Neurosurgery, University of Torino, Via Cherasco 15, 10126 Torino, Italy. pancy_pier@tiscali.it
Fontanella
M
M
Carlino
C
C
Bergui
M
M
Ducati
A
A
D000368:Aged; D002531:Cerebellum / Q000098:blood supply* / Q000473:pathology; D002533:Cerebral Angiography; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008297:Male; D012075:Remission, Spontaneous; D014711:Vertebral Artery / Q000002:abnormalities*