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Regression of cerebral arteriovenous malformation in the puerperium

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Abstract

Spontaneous regression of a cerebral arteriovenous malformation (AVM) is a rare occurrence. The authors describe a patient presenting with a ruptured AVM with a feeding artery aneurysm during second trimester of pregnancy. The feeding artery with aneurysm was clipped and the hematoma removed. The AVM subsequently spontaneously regressed by serial angiography during the postpartum period. The authors believe this is the first reported case of spontaneous regression of cerebral AVM early after pregnancy. The dramatic regression noted in the postpartum period in this case suggests the particular significance of hormonal factors in the dynamics of growth and rupture of an AVM.

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The authors have not received any financial support for this submission.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Utah School of Medicine, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA

    Sandrine M. Couldwell, Kristin L. Kraus & William T. Couldwell

Authors
  1. Sandrine M. Couldwell
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  2. Kristin L. Kraus
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  3. William T. Couldwell
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Corresponding author

Correspondence to William T. Couldwell.

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Comment

This case is worthy of inclusion to our body of knowledge of AVMs and vascular manifestations in pregnancy. I think there is no doubt that we can log this case as spontaneous regression of AVM, thanks to the beautiful documentation and elegant presentation that Dr. Couldwell and team give us here. Case reports are valuable only if they truly bring to light novel findings and if they are unimpeachable in their scientific documentation. This report fulfills both criteria, in my opinion. One must wonder, of course, how the authors will counsel this patient regarding future pregnancies and what sort of follow-up evaluations are planned even in the absence of pregnancy as the years go on. There are no easy answers to these issues. While the AVM has regressed for now, I am not personally confident that it is gone forever.

Christopher Loftus

Philadelphia, USA

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Couldwell, S.M., Kraus, K.L. & Couldwell, W.T. Regression of cerebral arteriovenous malformation in the puerperium. Acta Neurochir 153, 359–362 (2011). https://doi.org/10.1007/s00701-010-0897-x

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  • DOI: https://doi.org/10.1007/s00701-010-0897-x

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