Ulumuddin Muhammad Ikhya', Sani Achmad Firdaus, Kurniawan Dedy
Department of Neurology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Radiol Case Rep. 2023 Aug 3;18(10):3620-3625. doi: 10.1016/j.radcr.2023.07.040. eCollection 2023 Oct.
The most common manifestation of brain arteriovenous malformations (BAVM) is intracranial hemorrhage. The incidence of ruptured BAVM is 3.5 per 100,000 people per year. The mortality rate of ruptured BAVM within 1 month after diagnosis was 12.7%. Spontaneous thrombosis occurs in less than 1.5% of ruptured BAVMs. This phenomenon was still elusive. Up until now, the gold standard of imaging examination has been cerebral digital subtraction angiography (DSA), whose sensitivity and specificity reach 100%. We reported the spontaneous thrombosis of a ruptured deep BAVM. An 18-year-old woman presented with severe headache and vomiting. The patient also complained of seizures. There was no body weakness, skewed face, or slurred speech. Cerebral computed tomography (CT) showed extensive hemorrhage in the ventricular system and subarachnoid space. Cerebral DSA showed a left subcortical BAVM and was found to have spontaneous thrombosis 3 weeks later when the patient was about to be embolized. Spontaneous thrombosis of ruptured BAVM may occur after intracranial hemorrhage. In this patient, spontaneous thrombosis occurred within 3 weeks.
脑动静脉畸形（BAVM）最常见的表现是颅内出血。破裂性BAVM的发病率为每年每10万人中有3.5例。破裂性BAVM在诊断后1个月内的死亡率为12.7%。不到1.5%的破裂性BAVM会发生自发性血栓形成。这种现象仍然难以捉摸。到目前为止，影像学检查的金标准一直是脑数字减影血管造影（DSA），其敏感性和特异性均达到100%。我们报告了1例破裂性深部BAVM的自发性血栓形成。一名18岁女性出现严重头痛和呕吐。患者还主诉有癫痫发作。无肢体无力、面部歪斜或言语不清。脑计算机断层扫描（CT）显示脑室系统和蛛网膜下腔广泛出血。脑DSA显示左侧皮质下BAVM，3周后当患者即将接受栓塞治疗时发现有自发性血栓形成。破裂性BAVM的自发性血栓形成可能在颅内出血后发生。在该患者中，自发性血栓形成发生在3周内。
