Spontaneous thrombosis of high flow pediatric arteriovenous fistulae: Case series of two patients and a comprehensive literature review

Chen, Karen S.; Williams, Daniel Davila; Iacobas, Ionela; McClugage, Samuel G.; Gadgil, Nisha; Kan, Peter

doi:10.1007/s00381-023-06241-3

Childs Nerv Syst

2023

DOI: 10.1007/s00381-023-06241-3

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Spontaneous thrombosis of high flow pediatric arteriovenous fistulae: Case series of two patients and a comprehensive literature review

Karen S. Chen,

Daniel Davila Williams,

Ionela Iacobas

et al.

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2024

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Cited by 1 publication

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Long-term surveillance in an infant with spontaneous obliteration of pial arteriovenous malformation and large intranidal aneurysm: A unique case observation

Iampreechakul,

Wangtanaphat,

Wattanasen

et al. 2024

Surgical Neurology International

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Background: Spontaneous obliteration of untreated cerebral arteriovenous malformations (AVMs) is rare, occurring in <1% of cases, and is even less common in pediatric populations. The mechanisms driving spontaneous regression of brain AVMs remain poorly understood, and long-term surveillance in pediatric patients is infrequently documented. Case Description: The authors reported a remarkably rare instance of spontaneous thrombosis in a pial AVM accompanied by a large intranidal aneurysm in a 10-month-old infant, initially presenting with a nocturnal seizure. Diagnostic imaging revealed a ruptured intranidal aneurysm causing acute hemorrhage in the left anterior interhemispheric subdural space, extending into adjacent areas. Further, magnetic resonance imaging (MRI) and magnetic resonance angiography delineated the AVM in the left superior frontal gyrus, associated with a thrombosed aneurysm and surrounding edema. Cerebral angiography confirmed the AVM’s origin from the left anterior cerebral artery, displaying early venous drainage and small, indirect feeders not amenable to endovascular treatment. Over time, serial imaging showed the aneurysm’s transition from partial to complete thrombosis. Subsequent MRIs and angiographic assessments up to age 10 confirmed complete resolution of the AVM and aneurysm, with focal hyperemia persisted until age 16, when recurrent AVM was identified. Conclusion: We document a rare spontaneous regression of a pial AVM with an intranidal aneurysm influenced by specific vascular factors. Despite this, spontaneous thrombosis should not replace vigilant long-term monitoring in pediatric neurovascular care.

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Long-term surveillance in an infant with spontaneous obliteration of pial arteriovenous malformation and large intranidal aneurysm: A unique case observation

Iampreechakul,

Wangtanaphat,

Wattanasen

et al. 2024

Surgical Neurology International

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Spontaneous thrombosis of high flow pediatric arteriovenous fistulae: Case series of two patients and a comprehensive literature review

Cited by 1 publication

References 73 publications

Long-term surveillance in an infant with spontaneous obliteration of pial arteriovenous malformation and large intranidal aneurysm: A unique case observation

Long-term surveillance in an infant with spontaneous obliteration of pial arteriovenous malformation and large intranidal aneurysm: A unique case observation

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