Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA.
Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
Br J Neurosurg. 2024 Dec;38(6):1398-1401. doi: 10.1080/02688697.2021.2016621. Epub 2021 Dec 21.
Cerebral arteriovenous malformations (AVMs) have historically been considered congenital lesions with treatment options including surgery, radiation therapy, and observation. Spontaneous resolution of cerebral AVMs remains an exceedingly rare event with poorly understood pathophysiology.
Herein we report a retrospective case review of a 28-year-old man with alcoholic cirrhosis who presented with a seizure 3 weeks after liver transplantation. Neuroimaging confirmed the presence of a Spetzler-Martin grade 2 AVM in the right frontal lobe. Due to the recent liver transplantation, treatment was deferred at the time of initial diagnosis and the patient was observed for a course of 1 year. Follow-up imaging 1 year later showed resolution of the AVM, confirmed by a catheter angiogram.
Spontaneous resolution of cerebral AVMs is a rare event. Treatment of chronic liver disease resulted in the normalization of angiogenic factors that likely led to AVM resolution. This case provides valuable insight into the vital role of angiogenesis in the natural history of AVMs.
脑动静脉畸形（AVM）历来被认为是先天性病变，治疗方法包括手术、放射治疗和观察。脑 AVM 的自发消退仍然是一种极其罕见的事件，其病理生理学机制尚不清楚。
本文报告了 1 例 28 岁酒精性肝硬化患者的回顾性病例分析，该患者在肝移植后 3 周出现癫痫发作。神经影像学证实右侧额叶存在 Spetzler-Martin 分级 2 级 AVM。由于近期肝移植，初始诊断时推迟了治疗，患者接受了为期 1 年的观察。1 年后的随访影像学显示 AVM 消退，导管血管造影证实。
脑 AVM 的自发消退是一种罕见的事件。慢性肝病的治疗导致了血管生成因子的正常化，这可能导致了 AVM 的消退。该病例为血管生成在 AVM 的自然病程中的重要作用提供了有价值的见解。
