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Recurrent cerebral arteriovenous malformations after negative postoperative angiograms
A Kader1, J T Goodrich, W J Sonstein
1Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Journal of Neurosurgery
|July 1, 1996
Summary
Recurrent cerebral arteriovenous malformations (AVMs) can occur in children despite negative initial angiograms. Delayed imaging is recommended for pediatric patients to detect AVM regrowth, suggesting AVMs may not be solely congenital.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Vascular Malformations
Background:
- Cerebral arteriovenous malformations (AVMs) are traditionally considered cured if postoperative angiography shows no residual nidus.
- Negative angiograms post-treatment are assumed to eliminate hemorrhage risk.
Purpose of the Study:
- To describe cases of recurrent AVMs in children after initially negative postoperative angiograms.
- To investigate the possibility of AVM regrowth in pediatric patients.
Main Methods:
- Case series of five pediatric patients with recurrent AVMs.
- Review of initial and follow-up angiographic and imaging studies.
- Comparison with a large cohort of adult AVM patients.
Main Results:
- Five pediatric patients experienced AVM recurrence 1-9 years after negative postoperative angiograms.
- Recurrences presented with hemorrhage, seizures, or were detected on MRI.
- No AVM recurrence was observed in 667 adult patients after complete surgical removal.
Conclusions:
- AVM recurrence in children after negative angiography is possible and may involve AVM regrowth.
- Pediatric cerebral vasculature and angiogenesis might contribute to recurrence.
- Delayed imaging follow-up is crucial for children treated for AVMs.