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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Functional and educational outcomes after treatment for intracranial arteriovenous malformations in children

Max J van Essen1, Kuo Sen Han1, Rob T H Lo2

  • 1Department of Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.

Acta Neurochirurgica
|September 8, 2018
PubMed

Insights

Pediatric brain arteriovenous malformations (AVMs) treatment leads to excellent long-term functional and educational outcomes. Most children achieve good recovery and regular schooling after multidisciplinary care for intracranial AVMs.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Vascular Malformations

Background:

  • Arteriovenous malformations (AVMs) are rare in children but are the leading cause of hemorrhagic stroke.
  • While neurological recovery in children is often favorable, long-term functional and educational outcomes require further investigation.
  • This study evaluates long-term results beyond neurological status in pediatric intracranial AVMs.

Purpose of the Study:

  • To assess the long-term functional outcomes of children treated for intracranial AVMs.
  • To evaluate the educational attainment of these children compared to the general population.
  • To analyze outcomes following a multimodality treatment approach for pediatric brain AVMs.

Main Methods:

  • Retrospective review of pediatric patients treated for intracranial AVMs between 1998 and 2016.
  • Functional outcomes assessed using the modified Rankin scale (mRs).
  • Educational levels compared to age-matched controls using the International Standard Classification of Education (ISCED).

Main Results:

  • 25 children (mean age 10 years) were included; 76% presented with hemorrhage.
  • Mean follow-up was 11.5 years; 92% achieved an mRs of 0 or 1 at follow-up.
  • All patients followed regular education, with no significant difference compared to the general population.

Conclusions:

  • Multidisciplinary treatment of pediatric brain AVMs yields positive long-term functional outcomes.
  • Children treated for intracranial AVMs demonstrate normal educational development.
  • This study highlights the benefits of a comprehensive approach to pediatric AVMs.
Abstract

Keywords:
Arteriovenous malformationDevelopmentEducationFunctional outcomesMultimodality treatmentPediatrics

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