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Ruptures of arteriovenous malformations in children associated with trivial head trauma
T Nishi1, Y Matsukado, T Marubayashi
1Department of Neurosurgery, Kumamoto University Medical School, Japan.
Insights
Pediatric arteriovenous malformations (AVMs) can rupture from minor head injuries, particularly in younger children. These cases highlight a potential link between mild head trauma and AVM rupture in pediatric patients.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Vascular Neurology
Background:
- Cerebral arteriovenous malformations (AVMs) are congenital vascular anomalies.
- Rupture of AVMs can lead to significant neurological deficits.
- The role of minor head trauma in pediatric AVM rupture is not well-established.
Observation:
- Three pediatric cases of ruptured cerebral AVMs following trivial head trauma are presented.
- These cases constituted 12.5% of 25 consecutive pediatric AVM patients.
- Patients ranged from 5 to 9 years old, younger than non-traumatic AVM counterparts.
Findings:
- Trauma direction was anteroposterior or posteroanterior in all cases.
- Accompanying hematomas were subcortical in the parietal or temporal lobes.
- Feeding arteries originated from the anterior or middle cerebral arteries.
Implications:
- Minor head trauma may precipitate AVM rupture in susceptible children.
- Understanding trauma mechanisms is crucial for pediatric AVM management.
- Further research is needed to elucidate the pathophysiology of traumatic AVM rupture in children.
Abstract:
Three cases of ruptured arteriovenous malformations (AVMs) in childhood associated with trivial head trauma are reported. These patients represented 12.5% of 25 consecutive patients with cerebral AVMs. The patients' ages ranged from 5 to 9 years; the patients were younger than their nontraumatic counterparts. The force of the trauma was presumably received in an anteroposterior or posteroanterior direction in all cases. Hematomas accompanying the AVMs were located in the subcortical area of the parietal or temporal lobe and angiographically their feeding arteries were all from the anterior cerebral artery or middle cerebral artery. The possible mechanisms for the rupture of AVMs after trivial head trauma are discussed.