Arteriovenous Malformations of the Brain in Children: A Forty Year Experience

  title={Arteriovenous Malformations of the Brain in Children: A Forty Year Experience},
  author={Douglas Kondziolka and Robin P. Humphreys and Harold J. Hoffman and E. Bruce Hendrick and James M. Drake},
  journal={Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques},
  pages={40 - 45}
  • D. KondziolkaR. Humphreys J. Drake
  • Published 1 February 1992
  • Medicine
  • Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
ABSTRACT: Despite the great capacity for the pediatric brain to recover from stroke, the morbidity and mortality in children who harbor an arteriovenous malformation (AVM) remains high. This study examines the clinical data and management experience with 132 patients with brain AVM from 1949 to 1989. Although the high tendency for a childhood AVM to present with hemorrhage (79%) remained constant for the forty year study period, the associated morbidity and mortality of hemorrhage changed. The… 

Surgical management of arteriovenous malformations in children.

Children with AVMs may be more prone than adults to present with a hemorrhage and to experience recurrence of the lesion after treatment, and embolization as a preoperative strategy for Grades II to V lesions treated surgically is favored.

[Arteriovenous malformations of the brain in children: treatment results for 376 patients].

Early relapses of hemorrhage are not characteristic for children with cerebral AVM, there are no indications for urgent surgery except for cases of intracerebral hematoma, and it is unreasonable to postpone AVM radiosurgical treatment in children with increased risk of recurrent hemorrhage.

Cerebral Arteriovenous Malformations in Children

This study seems to support the role of AVM embolization and radiosurgery as effective adjuvant techniques in the management of cerebral AVMs in children and the factors which were more closely predictive of patients' outcome were the occurrence of an AVM bleeding and the neurological status on admission.

Cerebral arteriovenous malformations in children

The successful management of anaesthesia either for embolization or surgical resection necessitates an understanding of the disciplines of paediatric and neuroanaesthesia, and special care and specific attention to detail may contribute to reduce the high morbidity and mortality encountered in these compromised children.

Cerebellar arteriovenous malformations in children

The severity of clinical presentation was directly related to the size of the acute haematoma, which was a reasonable predictor of outcome, and vascular pathology other than an AVM was found in 14 children with a ruptured cerebellar AVM who had angiography.

Brain ArterioVenous Malformation in Children . Always a Late Diagnosis

Two cases presented are examples of where the AVM diagnosis was established following the rupture of the malformation and was clearly identifiable after angiography and treatable with endovascular embolization.

The effect of age on arteriovenous malformations in children and young adults undergoing magnetic resonance imaging

AVM prevalence on MRI significantly increased with age, and is seen more frequently on MRI with advancing age in children and young adults.

Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations

Hemorrhagic presentation was more common in children than in adults, and was also reflected as lower prevalence of epileptic presentation in the pediatric cohort, which correlated negatively with incidentally and epilepsy-diagnosed AVMs.



Natural history of arteriovenous malformations of the brain: a clinical study.

The natural history of intracranial arteriovenous malformations (AVMs) was studied in 131 patients, and recurrent posterior fossa hemorrhage was the rule in survivors, and most of those hemorrhages were fatal.

Prognosis for arteriovenous malformations of the brain in adults based on 150 cases.

Bleeding from cerebral arteriovenous malformations as part of their natural history.

Bleeding occurred most frequently in the 11- to 35-year-old age group, and the risk of rebleeding increased with advancing age, while size of the AVM was significantly related to therisk of first hemorrhage.

The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment.

There was no difference in the incidence of rebleeding or death regardless of presentation with or without evidence of hemorrhage, and the combined rate of major morbidity and mortality remained essentially constant over the entire period of the study.

Natural course of unoperated intracranial arteriovenous malformations: study of 50 cases.

Small and deep-seated AVM's were associated with a high incidence of bleeding; however, repeated hemorrhages were not necessarily indicative of a poor prognosis and children younger than 15 years had a better prognosis than adults.

Intracranial arteriovenous anomalies of infancy: modern concepts.

Computed tomographic scanning was invaluable in delineating the site of the lesion while arterial digital subtraction angiography was utilized to obtain the high-quality images, reduced dye volume and rapid filming.

Surgical excision of cerebral arteriovenous malformations: late results.

A follow-up study of 153 consecutive patients who underwent complete excision of an angiographically visualized intracerebral arteriovenous malformation was conducted, finding that over half of the patients who had seizures before surgery were either cured or greatly improved with respect to the seizures.

Cerebral arteriovenous malformations in children (56 cases).

The clinical manifestation was mostly related to hemorrhage, less frequently to epilepsy or to a cerebral 'steal' syndrome, and the most frequent site was the parietal lobe, with supply from the middle cerebral artery.

Surgical management of epilepsy associated with cerebral arteriovenous malformations.

Proposed mechanisms of seizure associated with cerebral AVM include focal cerebral ischemia secondary to arteriovenous shunting, gliosis of the surrounding brain, and a secondary epileptogenesis in the temporal lobe.