Arteriovenous malformation surgery in children: the Rady Children's Hospital experience (2002-2019)

Area of Science:

• Neurosurgery
• Pediatric Neurology
• Vascular Malformations

Background:

• Pediatric brain arteriovenous malformations (AVMs) are rare, and data on their microsurgical treatment is limited.
• Understanding treatment outcomes is crucial for managing these complex vascular lesions in children.

Purpose of the Study:

• To report the institutional experience with microsurgical resection of pediatric AVMs.
• To evaluate the efficacy and safety of microsurgical resection, with or without adjunctive therapies, for pediatric AVMs.

Main Methods:

• Retrospective review of patients aged 18 years or younger with cerebral AVMs treated between 2002 and 2019.
• Analysis of patient demographics, AVM characteristics, treatment modalities (microsurgery, embolization, radiation), outcomes, and complications.

Main Results:

• Eighty-nine pediatric patients were included; 81% presented with ruptured AVMs.
• Radiographic obliteration was achieved in 85.4% of patients, with a 1.2% annualized rebleeding rate and 0.9% recurrence rate.
• A good neurological outcome (mRS ≤ 2) was achieved in 80.9% of patients, with 75% showing improvement from presentation.

Conclusions:

• Microsurgical resection is an effective treatment for pediatric brain AVMs, yielding high obliteration rates.
• The study demonstrates a low incidence of neurologic complications and AVM recurrence following treatment.