Cerebral arteriovenous malformations in children

Arterio-venous malformations in childhood: Clinical presentation, results after operative treatment and long-term follow-up

“…All authors agree that these should be operated upon [1,3,4,5,7,8,9,10,12,13]. The opinions about angiomas which have not bled are conflicting; especially large angiomas with many arterial feeders and those, which involve a hazardous area of the brain, cause a serious therapeutic dilemma.…”

“…Although AVMs are responsible for 3 0 -50% of the hemorrhagic strokes in childhood, only few authors paid attention to the problems of this special age group [1,5,6,10,13]. Besides discussion of the natural history of AVMs and the question, which of them are likely to bleed and should be operated upon, no attempt has been made for a long-term follow-up after successful surgical excision of AVMs in childhood.…”

Cerebral arteriovenous malformations in childhood: state of the art with special reference to treatment

“…Seizures may be the warning sign of an acute haemorrhage or the result of the epileptogenic effect of parenchymal depo sition following old haemorrhagic events. Headache is a symptom frequently afflicting AVM patients [26], Pro gressive neurological manifestations and mental deteri oration also occur and have been attributed to the an arterial steal phenomenon, determined by the sumping effect the AVM exerts on the intracranial circulation. Unruptured clinically silent AVMs can lead to mental retardation or slow behaviour [26].…”

“…Percentages of up to 25% of rebleeding within 5 years in children have been reported [46]. For some unclear reason, smaller AVMs in children have shown a higher tendency for bleeding [26]. Also, the younger the patient the greater the chance of recurrent haemorrhage from AVM [52].…”

“…The morbidity and mortality associated with cerebral AVM in neonates is high, especially in neonates who present with congestive cardiac failure. The overall mortality is around 20% [16,26,37].…”