High-Flow Vascular Malformations in Children

Abstract

Children can have a variety of intracranial vascular anomalies ranging from small and incidental with no clinical consequences to complex lesions that can cause substantial neurologic deficits, heart failure, or profoundly affect development. In contrast to high-flow lesions with direct arterial-to-venous shunts, low-flow lesions such as cavernous malformations are associated with a lower likelihood of substantial hemorrhage, and a more benign course. Management of vascular anomalies in children has to incorporate an understanding of how treatment strategies may affect the normal development of the central nervous system. In this review, we discuss the etiologies, epidemiology, natural history, and genetic risk factors of three high-flow vascular malformations seen in children: brain arteriovenous malformations, intracranial dural arteriovenous fistulas, and vein of Galen malformations.

Endovascular treatment in the multimodality management of brain arteriovenous malformations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee

“…This review does not address treatment for all brain arteriovenous shunting lesions in children, but instead is focused on brain AVMs with a nidus. Specifically, vein of Galen malformations, non-Galenic pial arteriovenous fistulas, and dural arteriovenous fistulas—which have varied presentations, sometime massive arteriovenous shunting, and different treatments—are not included here 132–135. Nidus AVMs in children can be approached in similar fashion to those in adults, with a few caveats 136–139.…”

Microsurgical resection of high-flow cerebral arteriovenous malformations after recurrent stroke

“…Arteriovenous malformations (AVMs) are congenital anomalies of the intracranial vessels that comprise a direct communication between the arterial blood vessels and venous systems and come up short on an interceding capillary bed. The absence of obstruction inside the nidus prompts high-f low shunting of blood among blood vessels and venous courses [1]. Hemorrhagic introduction of AVM is an autonomous indicator of future hemorrhage and it is associated with significant morbidity and mortality.…”