Delayed ischemic stroke following spontaneous thrombosis of an arteriovenous malformation.

Spontaneous obliteration of an arteriovenous malformation (SOAVM) is a rare event that is not completely understood. Less than 100 cases of SOAVMs have been reported in the literature. We present a unique case of a middle-aged patient with spontaneous obliteration of a cerebral arteriovenous malformation (AVM) who developed an ischemic stroke due to thrombosis of the stagnant proximal segment of the inferior branch of the middle cerebral artery feeder. Although the pathophysiology is not well understood, the arterial feeder hemodynamic changes post SOAVM may behave similarly to what occurs in rare cases after surgical resection of AVMs. Our case raises the hypothesis that stagnation of flow in spontaneous AVM obliteration may lead to delayed ischemic stroke in the territory of the feeding artery.