Growth of Flow-Related Aneurysms Following Occlusion of Cerebral Arteriovenous Malformation

Abstract

Background Flow-related aneurysms (FRAs) associated with cerebral arteriovenous malformations (AVMs) pose a significant therapeutic challenge. Both their natural history and management strategy are still unclear and underreported. FRAs generally increase the risk of brain hemorrhage. However, following AVM obliteration these vascular lesions are expected to disappear or remain stable.

Methods We present two cases where growth of FRAs was detected following complete obliteration of an unruptured AVM.

Results The first patient presented with proximal middle cerebral artery (MCA) aneurysm growth after spontaneous and asymptomatic thrombosis of the AVM. In our second case, a very small aneurysmal-like dilation located at the basilar apex enlarged to a saccular aneurysm following complete endovascular and radiosurgical obliteration of the AVM.

Conclusion The natural history of flow-related aneurysms is unpredictable. In the cases where these lesions are not managed first, there should be close follow-up. When aneurysm growth is evident, active management strategy seems mandatory.

Keywords

aneurysm growth - AVM occlusion - flow-related aneurysms

Ethical Approval

This study was approved by the Medical Center Institutional Review Board for human research.

Informed Consent

Informed consent was obtained from all individual participants in the study.

Publication History

Received: 23 October 2022

Accepted: 13 February 2023

Accepted Manuscript online:
17 February 2023

Article published online:
26 July 2023

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