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Comparison of pediatric and adult cerebral arteriovenous malformations
G D'Aliberti1, G Talamonti, P P Versari
1Department of Neurosurgery, Niguarda Ca' Granda Hospital, Milan.
Insights
Children with cerebral arteriovenous malformations present with smaller lesions but more severe symptoms than adults. Despite this, pediatric patients demonstrate better outcomes, suggesting potential differences in lesion evolution and management effectiveness.
Area of Science:
- Neurology
- Vascular Surgery
- Pediatric Neurosurgery
Background:
- Cerebral arteriovenous malformations (AVMs) are complex vascular lesions in the brain.
- Understanding age-related differences in AVM presentation and outcomes is crucial for effective treatment.
Purpose of the Study:
- To compare clinical and angiographic features, treatment, and outcomes of pediatric versus adult cerebral AVMs.
- To investigate potential differences in lesion characteristics and patient prognosis between age groups.
Main Methods:
- Retrospective review of 19 pediatric and 120 adult cerebral AVM cases managed between 1978-1992.
- Comparison of clinical presentation, angiographic findings, treatment strategies, and patient outcomes.
Main Results:
- Pediatric AVMs were smaller and simpler in structure compared to adult AVMs.
- Children experienced more severe initial clinical presentations but exhibited better outcomes than adults.
- Treatment modalities and outcomes were analyzed and contrasted between the two groups.
Conclusions:
- Cerebral AVMs in children differ significantly from those in adults regarding lesion characteristics.
- Despite more severe initial symptoms, children with cerebral AVMs appear to have a more favorable prognosis.
- The potential for AVM evolution in the brain warrants further investigation.
Abstract:
The authors report 19 consecutive children with cerebral arteriovenous malformations over the period 1978-1992. These patients are compared with a series of 120 consecutive adult patients with the same pathology, managed during the same period. The main clinical and angiographic features, as well as the treatment modalities and outcome are reviewed and compared. Children seem to harbour smaller and simpler lesions than adults. Furthermore, despite a more severe clinical presentation, children appears to fare better than adults. The possibility of evolution of brain arteriovenous malformations is discussed.