Partial spontaneous regressive arteriovenous malformation; case report with angiographic evidence.

Abstract

HE natural history of patients harboring arteriovenous malformations of the brain has been studied by several investigators with varying conclusions. Paterson and McKissock ~2 noted only three fatal hemorrhages in 42 untreated patients. Schatz, et al., ~6 reported a series of 118 patients, 50% of whom either died or became permanently disabled. Poop * presented a series of 220 patients who were not surgically treated, 19 % of whom died as a result of the arteriovenous malformation; his combined figure for morbidity and mortality was 40%. Svien and McRae 17 discussed the problem and concluded that 80% to 85% could be treated conservatively. Spontaneous regression of an arteriovenous malformation has been reported infrequently. Cushing and Bailey 4 discussed the case of a 64-year-old man who was operated on twice for an arteriovenous malformation. The vascular anomaly was calcified, and in 1924 the patient received 16 radiation treatments, not so much for the vascular anomaly as for the possibility of there being a neoplasm. At the second operation 3 years later, the arteriovenous malformation had decreased in size and was removed. In citing Cushing's case, Pool and Potts ~4 remarked that when advanced arteriosclerosis is present there is the possibility that the vascular malformation may undergo thrombosis. Ho/Sk and Johanson 8 reported a patient with an arteriovenous malformation in the left frontoparietal region which was demonstrated by angiography in 1934. This patient had hydrocephalus due to an obstruction at the foramen of Monro which was caused by a dilated vein. They reestablished the inter