Cerebral arteriovenous malformations in children: report on 62 cases

Abstract

A series of 62 children with cerebral arteriovenous malformations admitted to our department in the course of 17 years (1975-1992) was reviewed in a retrospective study. In 54 cases hemorrhagic stroke was the first presenting symptom, followed by epilepsy in five cases. On admission 26 children presented with a neurological deficit, and 21 were admitted with a grade 3 status according to Botterell. Fifty-one malformations were supratentorial (41 hemispheric, 10 deep-seated) while 11 were infratentorial. According to Mori's criteria, 28 lesions were small, 19 medium, and 15 large. Fifty-two children were operated on, with total excision of the malformation achieved in 47 cases. In two children the malformation recurred. The evolution of neurological disorders has been studied with a mean follow-up of 8.5 years. Fifty patients had a satisfactory outcome on the Glasgow Outcome Scale. Four children died. These results were compared with those reported elsewhere in the pediatric literature.

Gamma Knife surgical treatment for partially embolized cerebral arteriovenous malformations

“…7,19,22,25,30,34 According to reports, 0.1% of the population harbors an AVM, 3,8 and both sexes are equally affected. AVMs are the leading cause of nontraumatic intracerebral hemorrhage in people less than 35 years old.…”

Hemorrhagic Stroke: Clinical, Etiologic and Evolutive Aspects in Senegalese Children

“…The average age of onset of hemorrhagic stroke was 9.85 years with extremes of 2 months and 18 years [5][6][7][8][9]. The onset of symptoms was sudden or rapidly progressive in a few hours in all patients.…”

Recurrent Cerebral Arteriovenous Malformation in a Child : Case Report and Review of the Literature

“…Hladky et al 9) documented two cases of recurrence, one located in the corpus callosum and the other located in the parietal lobe, among the 62 pediatric cases in which AVM surgery had been performed. They suggested that recurrence caused by microshunts might remain invisible on early postoperative angiography.…”

“…Arteriovenous malformation (AVM) is the most frequent cause of hemorrhage in children 9) . Complete excision or obliteration of the lesion usually eliminates the risks of hemorrhage, and a negative cerebral angiogram is generally considered indicative of a cure.…”

“…Complete excision or obliteration of the lesion usually eliminates the risks of hemorrhage, and a negative cerebral angiogram is generally considered indicative of a cure. Although recurrence of cerebral AVMs is rare, there are several reports of cerebral AVM recurrence in both children 1,2,4,[9][10][11] and adults 3,5,8,16) after complete resection verified by postoperative angiography.…”