Arteriovenous Malformations of the Brainstem in Childhood

Abstract

Brainstem vascular malformations are an uncommon but lethal problem in pediatric neurosurgery. 9 children with confirmed vascular malformations in the brainstem are presented, and the treatment options considered. The recent encouraging results concerning the operative management of these lesions, deserves fullest consideration with the hope that an aggressive management plan can be instituted for the child who otherwise will experience repeated hemorrhage and die from the malformation.

Cerebral arteriovenous malformations in childhood: state of the art with special reference to treatment

“…The mortality in patients with an AVM in the fossa posterior is far higher than that of an AVM in the supratentorial space [18], The prognosis of brainstem AVMs is very poor. In a series of nine patients with confirmed AVMs in the brainstem, the mortality, independent of treatment, was 67% [18]. In these nine children, in total 17 bleedings occurred.…”

“…In patients with a previous haemorrhage, the risk of AVM rebleeding has been es timated to be 6%, 13% and 47% by 1, 5, and 20 years respectively after the initial haemorrhage [10], There is evidence that children with AVMs have a higher risk of bleeding and rebleeding than adults [4,19]. Percentages of up to 25% of rebleeding within 5 years in children have been reported [46].…”

“…Children have approximately 24% mortality from their first haemorrhage, mainly dependent on the loca tion of the AVM [9,11,14,19]. The mortality in patients with an AVM in the fossa posterior is far higher than that of an AVM in the supratentorial space [18], The prognosis of brainstem AVMs is very poor.…”

Pediatrik Konjenital Vaskuler Malformasyonlarda Endovaskuler Tedavi

“…Humphreys ve ark. [30] 105 AVM'li pediatrik olguyu incelemiş ve 10 yıllık gözlem sonunda kanama riskinin %32 ve tek bir kanama sonrası ölüm oranının %24 olduğunu bildirmişlerdir. Ayrıca bu çalışmada operatif ölüm oranı %8 olup, bu oran kanama riskine göre daha düşüktür.…”

The combination of a bifocal germinoma and arteriovenous malformations of the brain in children. Clinical observation and review of the literature

“…К л и н и ч е с к о е н а б л ю д е н и е возрастных группах является внутричерепное кро-воизлияние, при этом в детской популяции частота кровоизлияний, по данным разных авторов, дости-гает 85 % [32,34,38]. Летальность при разрыве АВМ выше в детской популяции, чем у взрослых, и дости-гает 25 % [35].…”