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Childhood intracranial arteriovenous malformation in Saudi Arabia
B Y Sheikh1, M Hassounah, K Al-Moutare
1Department of Neurosurgery, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia.
Insights
Pediatric intracranial arteriovenous malformations (ICAVM) are rare, accounting for 7.72% of cases in Saudi Arabia. Most pediatric patients presented with bleeding or seizures, and had higher morbidity rates than adults.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Vascular Neurology
Background:
- Intracranial arteriovenous malformations (ICAVM) are complex vascular lesions.
- Pediatric ICAVM cases are infrequently studied, particularly in specific geographic regions.
- Understanding the epidemiology and clinical presentation of pediatric ICAVM is crucial for timely diagnosis and management.
Purpose of the Study:
- To determine the hospital-based frequency of pediatric intracranial arteriovenous malformations (ICAVM) in Saudi Arabia.
- To analyze the clinical presentation, characteristics, and outcomes of pediatric ICAVM patients.
- To establish the incidence of pediatric ICAVM within the broader context of all ICAVM cases in the region.
Main Methods:
- Retrospective review of pediatric patients (≤16 years) diagnosed with ICAVM.
- Data collected from three major tertiary care centers in Saudi Arabia.
- Analysis of patient demographics, clinical presentation, ICAVM grade, treatment modalities, and outcomes.
Main Results:
- Twenty-three pediatric patients with ICAVM were identified, representing 7.72% of all ICAVM cases studied.
- The primary presentations were intracranial bleeding (most common) and seizures.
- Pediatric patients often had higher-grade ICAVM, leading to increased morbidity compared to adults.
- Spontaneous changes in ICAVM size or vascularization were observed in 4 children.
- A 50% cure rate was achieved using various therapeutic interventions.
Conclusions:
- This study provides the first hospital-based frequency data for pediatric ICAVM in Saudi Arabia.
- Pediatric ICAVM presents predominantly with severe neurological events like bleeding and seizures.
- Higher morbidity rates in pediatric ICAVM underscore the need for specialized care and early intervention.
- The findings highlight regional variations in pediatric ICAVM incidence and characteristics.
Abstract:
Twenty-three patients in whom intracranial arteriovenous malformation (ICAVM) occurred while they were in the pediatric age group (16 years or less) were identified. The patients had presented to three major centers in Saudi Arabia (King Fahad Hospital of the University, King Faisal Specialist Hospital and Research Center, and Riyadh Military Hospital). The incidence of ICAVM in Saudi Arabia is estimated. ICAVM in the pediatric age group accounts for 7.72% of all ICAVM cases. Most of the pediatric patients presented with intracranial bleeding, and seizure was the only other mode of presentation. Spontaneous changes involving ICAVM occurred in 4 children, in the form of either increase or decrease in size or new vascularization. Most children had higher grade ICAVM and the morbidity rate was higher than in adults. The cure rate was 50% with different therapeutic modalities. This report represents the first study to provide the hospital-based frequency of pediatric ICAVM in Saudi Arabia.