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Arteriovenous malformations presenting with papilloedema

Lai-Wah Eva Fung1, Vijeya Ganesan

  • 1Neurosciences Unit, Institute of Child Health, University College London, London, UK.

Developmental Medicine and Child Neurology
|September 4, 2004
PubMed

Insights

Cerebral arteriovenous malformations (AVMs) can cause papilledema, a sign of increased intracranial pressure. Early visual assessment and timely management are crucial for pediatric patients with AVMs.

Area of Science:

  • Neurology
  • Ophthalmology
  • Pediatrics

Background:

  • Cerebral arteriovenous malformations (AVMs) are common vascular anomalies, often presenting with intracranial hemorrhage in pediatric patients.
  • Papilledema, a sign of elevated intracranial pressure, can be associated with AVMs, necessitating thorough neurological and visual assessment.

Observation:

  • Two pediatric cases of incidental cerebral AVMs associated with bilateral papilledema are presented.
  • Case 1: A 13-year-old male with a temporal lobe AVM, headache, and papilledema, treated with acetazolamide and stereotactic radiosurgery.
  • Case 2: A 14-year-old male with a posterior fossa AVM, asymptomatic neurologically but with papilledema, treated with embolization.

Findings:

  • Both patients presented with papilledema, indicating elevated intracranial pressure, despite one being asymptomatic neurologically.
  • Medical management (acetazolamide) and interventional procedures (stereotactic radiosurgery, embolization) led to resolution of papilledema and AVMs.
  • Visual acuity and visual fields remained normal in both patients throughout their management.

Implications:

  • Highlights the importance of visual assessment in pediatric patients diagnosed with cerebral AVMs, even in the absence of overt neurological symptoms.
  • Suggests a potential link between AVMs and raised intracranial pressure, emphasizing the need for prompt diagnosis and multidisciplinary management.
  • Demonstrates successful outcomes with both conservative and interventional treatment strategies for AVM-associated papilledema in children.

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