Spontaneous Regression Of An Unruptured Arteriovenous Malformation Due To Drainer Vein Thrombosis In A Patient With Protein S Deficiency: A Case Report And Literature Review
Noda, R., Akabane, A., Kawashima, M., Segawa, M., Tsunoda, S., & Inoue, T. (2023). Spontaneous Regression of an Unruptured Arteriovenous Malformation Due to Drainer Vein Thrombosis in a Patient with Protein S Deficiency: A Case Report and Literature Review. NMC case report journal, 10, 221–226. https://doi.org/10.2176/jns-nmc.2023-0056
View Original Source →Abstract
Spontaneous regression of an arteriovenous malformation (AVM) is a rare condition observed in 0.3%-1.3% of patients with AVMs and is most likely caused by hemorrhagic events. The regression of an unruptured AVM is rarer than that of a ruptured AVM. Moreover, due to its low frequency of occurrence, the etiology and natural course of spontaneous regression of an AVM is still unclear. This is the first report presenting a case of a spontaneous regression of an unruptured AVM caused by a gradual drainer vein thrombosis that was suspected to result from hypercoagulability due to protein S deficiency.
Case Details
Disease Location
Brain vasculature
Personal Characteristics
33-year-old woman
Clinical Characteristics
Diagnosed with an unruptured avm following an MRI performed to identify the cause of her loss of consciousness. A flow-related aneurysm was located at the bifurcation of the right pericallosal artery. One year after the first MRI, a follow-up MRI revealed perifocal edema of the nidus with an intravenous thrombosis of the draining vein. The feeding artery, which is the enlarged anterior cerebral artery, and the dilated vein of galen showed reduced diameters. Evaluation for the hypercoagulable state revealed protein s deficiency
Remission Characteristics
Repeated MRI images through 8 years revealed the gradual occlusion of the avm caused by thrombotic events in the draining vein, resulting in near-complete nidus obliteration.
Treatment & Mechanisms
Proposed Remission Mechanisms
Gradual obstruction by multiple small thromboses could have contributed to the favorable out- come.
Clinical Treatment
None reported
Non-Clinical Treatment
None reported