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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.72 no.11 São Paulo Nov. 2014

http://dx.doi.org/10.1590/0004-282X20140158 

Images in Neurology

Spontaneous complete regression of cerebral arteriovenous malformation

Regressão completa espontânea de malformação arteriovenosa cerebral

Lucas Alverne Freitas de Albuquerque1 

Jander Moreira Monteiro2 

Marcos Dellaretti1  3 

Gerival Vieira Junior1 

Atos Alves de Sousa1  3 

1Departamento de Neurocirurgia, Santa Casa de Belo Horizonte, Belo Horizonte MG, Brazil

2Escola Bahiana de Medicina e Saúde Pública, Salvador BA, Brazil

3Faculdade de Ciências Médicas de Minais Gerais, Belo Horizonte MG, Brazil


A 55 year-old man started with headaches in 2005. He underwent MRI that showed left frontal arteriovenous malformations (AVM) without evidence of hemorrhage. An arteriography revealed AVM supplied by the left anterior cerebral artery (Figures 1A and 1B).

Figure 1 (A) Early-phase left internal carotid artery angiogram showed an AVM supplied by the left anterior cerebral artery; (B) Delayed-phase left internal carotid artery angiogram shows an early-draining single vein which drains into the sagittal sinus. 

In 2010 the patient had an episode of cerebral hemorrhage confirmed with CT and MRI (Figures 2A, 2B and 2C). Referred to our service for treatment in 2012, when he was made a new arteriography that revealed complete spontaneous regression of the AVM1,2 (Figure 3).

Figure 2 (A) CT scan shows an intracerebral hematoma in the left frontal lobe; (B) Axial without gadolinium T1-weighted MR image suggests a hematoma. The tubular structures representing the AVM are seen as signal voids; (C) Sagittal gadolinium-enhanced T1-weighted MR image suggests a hematoma. The tubular structures representing the AVM are seen as high signal intensity. 

Figure 3 Left internal carotid artery angiogram revealed complete spontaneous regression of the AVM. 

Complete spontaneous regression of the AVM is extremely rare, with only few cases in literature and an estimated prevalence of 0.8 to 1.3%1,2,3.

References

. Abdulrauf SI, Malik GM, Awad IA. Spontaneous angiographic obliteration of cerebral arteriovenous malformations. Neurosurgery. 1999;44(2):280-7. http://dx.doi.org/10.1097/00006123-199902000-00021 [ Links ]

. Buis DR, Berg R, Lycklama G, Worp HB, Dirven CM, Vandertop WP. Spontaneous regression of brain arteriovenous malformations. A clinical study and a systematic review of the literature. J Neurol. 2004;251(11):1375-82. http://dx.doi.org/10.1007/s00415-004-0548-3 [ Links ]

. Patel MC, Hodgson TJ, Kemeny AA, Forster DM. Spontaneous obliteration ofpial arteriovenous malformations: a review of 27 cases. Am J Neuroradiol. 2001;22(3):531-6. [ Links ]

Received: May 16, 2014; Revised: August 05, 2014; Accepted: August 25, 2014

Correspondence: Lucas Alverne Freitas de Albuquerque; Rua Padre Rolim, 492 / ap.101; 30130-090 Belo Horizonte MG, Brasil; E-mail: lucasalverne@yahoo.com.br

Conflict of interest: There is no conflict of interest to declare.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.