We describe two rare cases of spontaneous closure of cerebral dural arteriovenous fistulas (DAVFs) with a small nidus and draining directly in a single cortical vein with several ectasias.
Eighteen previously published cases of spontaneous closure of cerebral DAVF comprised more benign fistula types. In literature, several explanations for DAVF occlusion have been proposed. We hypothesize that, in addition to the known causes, the specific contrast medium used during the diagnostic selective angiography might have played a role in the thrombosis and subsequent fistula closure.
BordenJAWuJKShucartWA: A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg82: 166–179, 1995.
2.
CognardCGobinYP: Cerebral dural arteriovenous fistulas: Clinical and angiographic correlation with a revised classification of venous drainage. Radiology194: 671–80, 1995.
3.
van RooijWJSluzewskiMBeuteGN: Dural arteriovenous fistulas with cortical venous drainage: Incidence, clinical presentation, and treatment. Am. J. Neuroradiol28: 651–655, 2007.
4.
SodermanMPavicL: Natural history of dural arteriovenous shunts. Stroke39: 1735–1739, 2008.
5.
AgidRTerBruggeK: Management strategies for anterior cranial fossa (ethmoidal) dural arterioveneous fistulae with emphasis on endovascular treatment. J Neurosurg110: 79–84, 2009.
6.
LucianiAHoudartE: Spontaneous closure of dural arteriovenous fistulas: Report of three cases and review of the literature. Am J Neuroradiol22: 992–996, 2001.
7.
SaitoAFurunoY: Spontaneous closure of transverse sinus dural arteriovenous fistula. Neurol Med Chir (Tokyo)48: 564–68, 2008.
MoriyaMItokawaH: Spontaneous closure of dural arteriovenous fistula after performing diagnostic angiography. No Shinkei Geka35: 65–70, 2007.
11.
BuisDRvan den BergR: Spontaneous regression of brain arteriovenous malformations — A clinical study and a systematic review of the literature. J Neurol251: 1375–1382, 2004.
12.
LeeSKVilelaP: Spontaneous regression of cerebral arteriovenous malformations: Clinical and angiographic analysis with review of the literature. Neuroradiology44: 11–16, 2002.
13.
SawlaniVHandiqueAPhadkeRT: Spontaneous regression of cerebral AVM due to thrombosis of draining vein-angiographic and MRI demonstration. J Neurol Sci223: 195–198, 2004.
14.
LeungKMAgidRTerBruggeK: Spontaneous regression of a cerebral arteriovenous malformation in a child with hereditary hemorrhagic telangiectasia. J Neurosurg105: 428–431, 2006.
15.
BarstadRMBuchmannMS: Effects of ionic and non-ionic contrast media on endothelium and on arterial thrombus formation. Acta Radiol37: 954–961, 1996.
16.
JonesCIGoodallAH: Differential effects of the iodinated contrast agents Ioxaglate, Iohexol and Iodixanol on thrombus formation and fibrinolysis. Thromb Res112: 65–71, 2003.