Cerebral arteriovenous malformations in children

Millar, Carol; Bissonnette, Bruno; Humphreys, Robin P.

doi:10.1007/bf03009913

Cited by 79 publications

(35 citation statements)

References 50 publications

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“…1 3 The relative incidence in other locations could be estimated from 10% to 38% of the cases. 2,5,7,14 It can be suspected that this incidence could be underestimated since undiagnosed or inadequately emergently treated acute hemorrhagic strokes could be a cause of out-ofhospital sudden deaths in previously healthy children.…”

Section: Discussionmentioning

confidence: 99%

Emergency management of deeply comatose children with acute rupture of cerebral arteriovenous malformations

Meyer

Orliaguet

Zérah

et al. 2000

Can J Anesth/J Can Anesth

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REPORTS O F INVESTIGATIONCAN J ANESTH 2000 / 47: 8 / pp [758][759][760][761][762][763][764][765][766] Purpose: To assess the impact of emergency management on mortality and morbidity of acute rupture of cerebral arteriovenous malformations resulting in deep coma in children, and the factors predicting outcome. Methods: Retrospective chart review of 20 children with a Glasgow Coma Scale # 8 with acute hemorrhagic stroke from a cerebral arteriovenous malformation rupture was conducted. Protocol included: early resuscitation with tracheal intubation and ventilation after induction of anesthesia with sufentanil, and benzodiazepine, and mannitol 20% or hypertonic saline 7.5% infusion for life-threatening brain herniation. Radiological exploration was limited to contrast-enhanced CT scan preceding immediate surgical decompression. Postoperatively, children were deeply sedated and intracranial pressure monitoring allowed titration with osmotherapy , vasopressors, hyperventilation or barbiturate coma to control cerebral perfusion pressure. Analysis used stratification of the type of hemorrhage (supra or infra tentorial), location (intraparenchymal and subarachnoid, intraparenchymal and intraventricular or intraventricular alone) and relationship between presentation, evolution with resuscitation, type of cerebral lesion, and outcome. Results: Patients had a severe initial presentation (median Glasgow Coma Scale five), eight had unilateral and eight bilateral third nerve palsy. Compressive hematoma in supratentorial localisation represented 75% of the cases. Global mortality was 40%. Persistence of mydriasis after resuscitation increased mortality to 75%. Massive intraventricular flooding was associated with increased mortality. Good functional outcome was achieved in survivors. Conclusion: Acute rupture of an AVM can result in rapidly progressing coma. Emergency management with early resuscitation, minimal radiological exploration before rapid surgical decompression results in a mortality rate of 40%, but a good functional outcome can be expected in the survivors.Objectif : Évaluer l'effet et le pronostic d'une intervention d'urgence sur la mortalité et la morbidité d'une rupture imprévisible de malformations artérioveineuses cérébrales qui ont conduit à un coma profond chez des enfants. Méthode : Un examen rétrospectif des dossiers de 20 enfants, cotés # 8 à l'échelle de Glasgow, qui ont subi un accident hémorragique aigu causé par la rupture de malformations artérioveineuses cérébrales, a été réalisé. Le protocole comportait : une réanimation précoce, une intubation endotrachéale et une ventilation après l'induction de l'anesthésie avec du sufentanil, du mannitol à 20 % ou une perfusion salée hypertonique à 7,5 % pour traiter l'hernie cérébrale grave. L'exploration radiologique s'est limitée à la scanographie de prise de contraste juste avant la décompression chirurgicale. Après l'opération, les enfants ont reçu une forte sédation. Le monitorage de la pression intracrânienne a permis le titrage de l'osmothérapie, des ...

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Section: Discussionmentioning

confidence: 99%

Emergency management of deeply comatose children with acute rupture of cerebral arteriovenous malformations

Meyer

Orliaguet

Zérah

et al. 2000

Can J Anesth/J Can Anesth

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“…Arteriovenöz malformasyonlar (AVM) arterio-kapiller ağın anormal gelişiminden kaynaklanan konjenital vasküler lezyonlardır [21]. AVM'lerin toplumdaki sıklığı %0,5, çocuklar-daki sıklığı ise 0.0014-0.028'dir [22].…”

Section: Pi̇al Avmunclassified

“…Beyinde hayatın herhangi bir döneminde belirti verebilir. Çocuklarda sıklıkla intrakraniyal kanama, konvülsiyon, hidrosefali ve daha nadiren yenidoğan döneminde konjestif kalp yetersizliği şeklinde karşımıza çıkarlar [21]. Gerek çocuk-larda gerekse de erişkinlerde kanama en sık görülen klinik bulgu olup, çocuklarda (%75-80), erişkinlere göre (%50-65) daha yaygındır.…”

Section: Pi̇al Avmunclassified

Pediatrik Konjenital Vaskuler Malformasyonlarda Endovaskuler Tedavi

Çınar¹,

Oran²

2018

Trd Sem

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“…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].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Immediate complications may occur during surgery in the form of an intraoperative bleeding, which of course can be fatal. Prolonged deep hypotension is often necessary to control the haemorrhage [37]. Delayed complications may occur in the postoperative period as a consequence of the altered haemodynamics in the brain after removal of an AVM.…”

Section: Surgerymentioning

confidence: 99%