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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Endovascular treatment of pediatric intracranial arteriovenous shunt

Yasunari Niimi1

  • 1Department of Neuroendovascular Therapy, St Luke's International Hospital, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|September 8, 2016
PubMed

Insights

Pediatric intracranial arteriovenous shunts (ICAVS) present with unique symptoms based on age and type. Endovascular treatment is preferred, with goals tailored to each child's specific condition.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Interventional Neuroradiology

Background:

  • Intracranial arteriovenous shunts (ICAVS) in children often involve high-flow fistulas.
  • The developing pediatric brain and cardiovascular system influence ICAVS presentation and symptoms.

Purpose of the Study:

  • To describe the age-specific clinical presentations of various pediatric intracranial arteriovenous shunt types.
  • To highlight the current treatment preferences and individualized approach for pediatric ICAVS.

Main Methods:

  • Review of clinical presentations and outcomes for different pediatric ICAVS.
  • Analysis of age-related symptomology and physiological impacts.

Main Results:

  • Neonates: Vein of Galen aneurysmal malformation (VGAM) and dural sinus malformations present with high output cardiac failure.
  • Infants: VGAM, pial arteriovenous fistula (AVF), and infantile dural AVF (DAVF) show hydrodynamic disorders like macrocephaly and developmental delay.
  • Older children: Pial AVF, AV malformation, and infantile DAVF can manifest with seizures or hemorrhage.

Conclusions:

  • Pediatric ICAVS exhibit distinct age-dependent clinical features.
  • Endovascular therapy is the primary treatment modality.
  • Treatment strategies must be individualized based on the child's unique physiological status.

Keywords:
arteriovenous fistulaarteriovenous malformationbrainembolizationpediatric

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