Spontaneous Thrombosis of an Unruptured Cerebral Arteriovenous Malformationin a Patient on Progesterone-Based Hormone Therapy: A Case Report

Authors

• Brandan T. Lykens, Lynchburg UniversityFollow

Specialty

Neurosurgery

Advisor

Jeffrey Oliver, MD

Abstract

Abstract

We present the case of a 43-year-old female with a history of migraine headaches, progesterone-based hormone replacement therapy, and remote epilepsy who presented with a persistent headache following a breakthrough seizure. Imaging revealed an unruptured right parietal arteriovenous malformation (AVM). Following her initial diagnosis, and prior to her index radiosurgery treatment, she was found to have evidence of spontaneous thrombosis. While seizures and headaches are common presenting features of cerebral AVMs, spontaneous thrombosis without rupture is exceedingly rare.

AVMs are typically managed based on hemorrhagic risk, as their natural course is more often associated with bleeding than thrombosis. In this case, progesterone-based hormone replacement therapy represents a potential contributor to hypercoagulability and was a potential contributing factor to AVM thrombosis. This case adds to the limited literature on spontaneous thrombosis of unruptured AVMs and highlights the potential role of systemic hypercoagulability in atypical AVM behavior.

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Recommended Citation

Lykens BT. Spontaneous Thrombosis of an Unruptured Cerebral Arteriovenous Malformationin a Patient on Progesterone-Based Hormone Therapy: A Case Report. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).