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Hemorrhage is the most common initial symptom of cerebral arteriovenous malformations (AVM) in children. Complete surgical removal of pediatric cerebral AVM is recommended to prevent future bleeding.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Vascular Malformations
Background:
- Cerebral arteriovenous malformations (AVM) are complex vascular lesions.
- Pediatric AVM present unique clinical challenges and management considerations.
Purpose of the Study:
- To review the clinical presentation and outcomes of pediatric cerebral AVM.
- To evaluate the effectiveness of different treatment modalities for pediatric cerebral AVM.
Main Methods:
- Retrospective review of 36 children under 13 with cerebral AVM.
- Analysis of initial manifestations, seizure occurrence, and treatment outcomes.
Main Results:
- Hemorrhage was the most frequent initial presentation of cerebral AVM in children.
- Seizures were the second most common manifestation, often associated with prior hemorrhage.
- Total surgical extirpation demonstrated the highest efficacy in preventing recurrent hemorrhage.
Conclusions:
- Hemorrhage is the predominant initial symptom in pediatric cerebral AVM.
- Complete surgical excision of pediatric cerebral AVM is the most effective strategy to prevent re-bleeding.
- Surgical intervention should be considered for all pediatric cerebral AVM when feasible.
Abstract:
A series of 36 children under the age of 13 with cerebral arteriovenous malformations (AVM) was retrospectively reviewed. It is shown that haemorrhage is by far the commonest initial manifestation of the lesion, followed by seizures. Of the 14 children who have seizures, 10 suffered from haemorrhage within an observation period of 3 months to 7 years. Analysis of the results of the various forms of treatment indicates that total surgical extirpation provides the best safeguard against future haemorrhage. It is suggested that all cerebral AVM in children should be excised whenever possible.