Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations

Abstract Background Intracranial arteriovenous malformation (AVM) in children is a rare diagnosis. Little is known about factors determining AVM rupture and appropriate treatment strategies to prevent hemorrhage and associated disability. Available data suggest that children are subject to an increa...

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Bibliographic Details
Published in:World neurosurgery 2016-05, Vol.89, p.540-551
Main Authors: Reitz, Matthias, MD, von Spreckelsen, Niklas, Vettorazzi, Eik, MSci, Burkhardt, Till, MD, Grzyska, Ulrich, MD, Fiehler, Jens, MD, Schmidt, Nils Ole, MD, Westphal, Manfred, MD, Regelsberger, Jan, MD
Format: Article
Language:English
Subjects:
Adolescent
Angioarchitecture
Angiography, Digital Subtraction
AVM
Brain - blood supply
Brain - diagnostic imaging
Cerebral Angiography
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - epidemiology
Cerebral Hemorrhage - etiology
Cerebral Hemorrhage - physiopathology
Child
Child, Preschool
Clinical outcome
Contrast Media
Female
Follow-Up Studies
Humans
Intracranial Arteriovenous Malformations - diagnostic imaging
Intracranial Arteriovenous Malformations - epidemiology
Intracranial Arteriovenous Malformations - physiopathology
Intracranial Arteriovenous Malformations - surgery
Magnetic Resonance Imaging
Male
Multivariate Analysis
Neurosurgery
Pediatric arteriovenous malformations
Risk Factors
Time Factors
Treatment Outcome
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Summary:Abstract Background Intracranial arteriovenous malformation (AVM) in children is a rare diagnosis. Little is known about factors determining AVM rupture and appropriate treatment strategies to prevent hemorrhage and associated disability. Available data suggest that children are subject to an increased risk for AVM rupture compared to adults. Methods In 46 pediatric AVM patients, demographic factors, clinical presentation, angioarchitectural features, treatment regimens as well as clinical and radiological outcomes were retrospectively analyzed. First-line treatment option was the microsurgical resection of the pathology, with or without preoperative embolization. Results 24 males (52.2%) and 22 females (47.8%) with a mean age on admission of 12.4 years (4-18 years) were included. Mean follow-up was 4 years (median 1.5; range 0.1-16.4). 31 children presented with intracerebral hemorrhage (67.4%). Small AVMs (
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2016.02.050