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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Radiosurgery for arteriovenous malformations in children
Aaron A Cohen-Gadol1, Bruce E Pollock
1Departments of Neurologic Surgery and Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Journal of Neurosurgery
|June 17, 2006
Summary
Stereotactic radiosurgery effectively treated pediatric arteriovenous malformations (AVMs) with minimal complications. A novel AVM score accurately predicted successful outcomes, guiding future treatment strategies for these complex vascular lesions.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Pediatric Neurology
Background:
- Arteriovenous malformations (AVMs) in children pose significant treatment challenges.
- Stereotactic radiosurgery (SRS) offers a minimally invasive therapeutic option for pediatric AVMs.
Purpose of the Study:
- To evaluate the efficacy and safety of SRS for pediatric AVMs.
- To identify factors predicting successful outcomes after SRS.
- To validate a novel radiosurgery-based AVM grading scale.
Main Methods:
- Retrospective analysis of 38 pediatric patients (≤18 years) treated with SRS between 1990-2001.
- Evaluation of AVM characteristics including Spetzler-Martin grade, location, and volume.
- Calculation of a radiosurgery-based AVM score.
- Assessment of outcomes based on AVM obliteration and new neurological deficits.
- Median follow-up of 42 months.
Main Results:
- 68% of patients achieved excellent outcomes (complete AVM obliteration, no new deficit).
- No permanent radiation-related complications were observed.
- A radiosurgery-based AVM score of 1 or lower correlated with significantly higher excellent outcomes (88% vs. 52%, p=0.03).
- Patient age, AVM volume, location, or Spetzler-Martin grade did not independently predict outcomes.
Conclusions:
- SRS is a successful and safe treatment modality for pediatric AVMs.
- The radiosurgery-based AVM score is a reliable predictor of treatment success.
- Long-term surveillance with angiography is recommended for obliterated AVMs in adulthood to detect potential recurrence.
