Spontaneous Occlusion of a Cerebral Arteriovenous Malformation: Angiography and MR Imaging Follow-up and Review of the Literature
Hilmar Krapfa,
Ralf Siekmanna,
Dirk Freudensteina,
Wilhelm Kükera and
Martin Skaleja
a From the Departments of Neuroradiology (H.K., R.S., W.K., M.S.), and Neurosurgery (D.F.), University of Tübingen, Germany.
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FIG 1. Cranial CT and MR imaging performed at presentation and 3 months.
A and B, Initial cranial CT scan shows a lobulated, calcified, 1.5-cm lesion in the central region with surrounding hypoattenuating white matter.
C and D, In axial T2-weighted images (4800/85 TR/TE), the lesion shows a hypointense signal because of calcifications, while the white matter changes appear hyperintense.
E, Sagittal reconstruction of T1-weighted fast low-angle shot 3D images (16.1/7 TR/TE) 20 minutes after chelated gadolinium injection reveals a slight contrast enhancement at the AVM nidus.
F, Three months later, one of the main draining veins appears hyperintense in this nonenhanced T1-weighted images, probably because of thrombus.
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FIG 2. Digital subtraction angiograms of the right interior cerebral artery. Lateral views (A, B) and anteroposterior views (C, D) in early arterial and late parenchymal phases show the high-flow central AVM, with two main feeders from the middle cerebral artery and venous drainage via superficial cortical veins into the superior sagittal sinus
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FIG 3. Follow-up digital subtraction angiograms of the right interior cerebral artery. Lateral views (A, B) and anteroposterior views (C, D) 4 months later fail to show the AVM nidus. Note the normal lumens of the former feeders
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