Pediatric intracranial arteriovenous shunts: Advances in diagnosis and treatment

Area of Science:

• Pediatric Neurology
• Vascular Malformations
• Interventional Neuroradiology

Background:

• Pediatric intracranial arteriovenous shunts (IAVSs) encompass diverse lesions like pial AVMs, AVFs, DAVFs, and VGAMs.
• These malformations are often linked to broader genetic conditions such as capillary malformation-arteriovenous malformation (CM-AVM) and hereditary hemorrhagic telangiectasia (HHT).
• The impact and presentation of IAVSs vary significantly across different pediatric age groups, from prenatal to childhood.

Purpose of the Study:

• To provide a comprehensive overview of pediatric intracranial arteriovenous shunts (IAVSs).
• To discuss current diagnostic approaches and endovascular treatment strategies for pediatric IAVSs.
• To enhance understanding of the associations between IAVSs and genetic syndromes like CM-AVM and HHT.

Main Methods:

• Literature review of pertinent scientific articles.
• Inclusion of representative clinical cases from the authors' institution.
• Synthesis of diagnostic criteria and endovascular management techniques.

Main Results:

• IAVSs present a spectrum of cerebrovascular lesions in children.
• Associated genetic conditions (CM-AVM, HHT) and their mutations are increasingly recognized.
• Age-specific symptoms and tailored endovascular treatment strategies are critical for effective management.

Conclusions:

• Improved understanding of pediatric IAVSs, their genetic underpinnings, and age-specific presentations is essential.
• Endovascular treatment plays a key role in managing these complex pediatric vascular lesions.
• This review aims to guide diagnosis and treatment strategies for pediatric IAVSs.