Spontaneous regression of multiple flow-related aneurysms following treatment of an associated brain arteriovenous malformation: A case report.

Andereggen, Lukas; Gruber, Philipp; Anon, Javier; Tortora, Angelo; Steiger, Hans-Jakob; Schubert, Gerrit A; Marbacher, Serge; Remonda, Luca (2022). Spontaneous regression of multiple flow-related aneurysms following treatment of an associated brain arteriovenous malformation: A case report. Frontiers in Surgery, 9(860416), p. 860416. Frontiers 10.3389/fsurg.2022.860416

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INTRODUCTION

There is no consensus in the treatment strategy of intracranial aneurysms (IAs) associated with brain arteriovenous malformation (BAVM). In particular, it is unknown if a more aggressive approach should be considered in patients harboring a BAVM, in whom multiple aneurysms or a history of aneurysmal subarachnoid hemorrhage (aSAH) is present.

CASE PRESENTATION

We report on an elderly woman harboring multiple aneurysms with a history of SAH due to rupture of an unrelated IA. On evaluation, she was also found to harbor a contralateral, left parietal convexity BAVM. Following resection of the latter, spontaneous regression of two large flow-related aneurysms was encountered.

DISCUSSION

We discuss the therapeutic decision-making, risk stratification, and functional outcome in this patient with regard to the pertinent literature on the risk of hemorrhage in IAs associated with BAVM.

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