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Linear vein-based arteriovenous malformations in children.

Cormac O Maher1, R Michael Scott

  • 1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan48109-5338, USA. cmaher@mich.edu

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A common pattern in pediatric arteriovenous malformations (AVMs) is a linear, vein-based morphology. Surgical treatment targeting this vein-based pattern can minimize disruption to the brain.

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Published on: November 2, 2016

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Vascular Malformations

Background:

  • Arteriovenous malformations (AVMs) are complex vascular anomalies.
  • Understanding the angioarchitecture of pediatric AVMs is crucial for surgical planning.
  • A specific linear, vein-based pattern has been observed in some pediatric AVMs.

Purpose of the Study:

  • To review surgical treatment outcomes for pediatric AVMs.
  • To analyze the angioarchitectural features of these AVMs.
  • To investigate the prevalence and implications of a linear vein-based AVM pattern.

Main Methods:

  • Retrospective review of pediatric AVM cases treated by a single surgeon over 15 years.
  • Inclusion criteria: pediatric age, pial AVM resection.
  • AVMs classified as linear-based if featuring a single, dominant linear vein.

Main Results:

  • Sixty-seven pediatric patients underwent AVM surgery.
  • 46% of AVMs exhibited a linear, vein-based configuration.
  • Hemorrhage was the most common presentation (61%), followed by incidental findings (16%) and seizures (13%).
  • Recurrence occurred in 4 cases (6%) after initial complete resection.

Conclusions:

  • A linear vein-based morphology is a frequent characteristic of pediatric AVMs.
  • This pattern may reflect embryological development of cerebral circulation.
  • Vein-based surgical approaches offer a targeted strategy with minimal cortical disruption.