Progressive spontaneous occlusion of a cerebellar AVM: pathogenetic hypothesis and review of literature

Clin Neurol Neurosurg. 2008 May;110(5):502-10. doi: 10.1016/j.clineuro.2008.01.009. Epub 2008 Mar 7.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cerebellum / blood supply*
  • Cerebellum / pathology
  • Cerebral Angiography
  • Follow-Up Studies
  • Functional Laterality
  • Humans
  • Intracranial Arteriovenous Malformations / complications
  • Intracranial Arteriovenous Malformations / diagnostic imaging
  • Intracranial Arteriovenous Malformations / pathology*
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / etiology*
  • Intracranial Hemorrhages / pathology
  • Male
  • Remission, Spontaneous
  • Vertebral Artery / abnormalities*