Spontaneous Regression of a Cerebral Arteriovenous Malformation : Case Report

概要

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We report a case in which an arteriovenous malformation (AVM) located in the thalamus underwent marked regression, as demonstrated by cerebral angiograms made 14 years after onset. The development of the AVM was accompanied with a massive triventricular hemorrhage, and such symptoms of elevated intracranial pressure as a serious impairment of consciousness, pupillary edema, and bilateral paresis of the abducent nerve. The AVM had a maximum diameter of 2.5 cm, and was fed by the thalamostriate artery and drained by the vein of Galen. Ventriculoperitoneal shunting was undertaken to control intracranial hypertension. Fourteen years later, a high pressure hydrocephalus due to a failure in shunting necessitated shunt reconstruction surgery. Cerebral angiography revealed that the maximum diameter of the AVM was 1 cm, indicating a major decrease in size, and that the drainage route through the Galenic vein was no longer patent. Regarding the mechanism whereby the AVM regressed in this case, circulatory disturbance in the drainage vein system that resulted from the repeatedly elevated intracranial pressure was probably a major factor.
北里大学の論文
2000-06-30