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European Journal of Pediatrics

, Volume 140, Issue 3, pp 260–267 | Cite as

Intracranial arteriovenous malformations and aneurysms in childhood and adolescence

  • U. Schauseil-Zipf
  • F. Thun
  • K. Kellermann
  • S. Mandl-Kramer
  • K. auf der Haar
Original Investigations

Abstract

Clinical data of 19 arteriovenous malformations (AVM) and 15 aneurysms (AN) are presented. Combined clinical, neurophysiological and neuroradiological follow-up studies have been carried out on the surviving patients (14 AVM and 10 AN). Two patients with multiple AN had coarctation of the aorta. Three AVM of the Vein of Galen showed typical symptoms within the 1st years of life, all other lesions became evident later than 5 years of age. In the acute phase of the disease clinical history and neurological deficits of AVM and AN tend to be very similar. Subarachnoid hemorrhage with or without intracranial hematoma is the most frequent initial symptom. A CT scan is valuable as a first orientating investigation but morphology and operability of the vascular lesion is only demonstrated by angiography.

The prognosis of AVM and AN is promising as soon as the first critical period has been survived. AVM patients show significantly less severe residual neurological and psychiatric defects than AN cases. EEG-follow-up studies and CT scans are helpful for controlling residual functional and morphological cerebral damage in survivors.

Key words

Cerebral arteriovenous malformations Aneurysm Pediatrics Diagnosis Follow-up studies 

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References

  1. 1.
    Amacher AL, Drake CG (1975) Cerebral artery aneurysms in infancy, childhood and adolescence. Childs Brain 1:72–80Google Scholar
  2. 2.
    Carrea R, Schuster G, Guevara JA, Girado JM, Taraturo AL (1974) Classification and specific clinical signs of cerebrovascular disease in children. Recent progress in neurol surgery. Excerpta Midical Amsterdam, pp 21–36Google Scholar
  3. 3.
    Friede RL (1975) Developmental neuropathology. Second part: Malformations and dysplasia of cerebral vasculature. Springer, Wien New York, p 365Google Scholar
  4. 4.
    Gerosa M, Licata C, Fiore DL, Iraci G (1980) Intracranial aneurysms in childhood. Childs Brain 6:295–302Google Scholar
  5. 5.
    Gomez MR, Whitten CF, Nolke A, Bernstein J, Meyer JS (1963) Aneurysmal malformation of the great vein of Galen causing heart failure in early infancy. Pediatrics 31:400–411Google Scholar
  6. 6.
    Harwood-Nash DC, Fitz CR (1976) Abnormalities of the cerebral arteries. Neuroradiology in infants and children. Mosby, St. Louis, pp 902–929Google Scholar
  7. 7.
    Isler W (1981) Zerebrovaskuläre Krankheiten im Kindesalter. In: Hirt HR (ed) Aktuelle Neuropädiatrie III. Thieme, Stuttgart, pp 26–36Google Scholar
  8. 8.
    Jacobi G, Vettermann H (1981) Aneurysmen der Vena magna Galeni und andere vaskuläre Malformationen der inneren Venen beim Kind. In: Hirt HR (ed) Aktuelle Neuropädiatrie III. Thieme, Stuttgart, pp 67–82Google Scholar
  9. 9.
    Kelly JJ, Mellinger JF, Sundt TM jr (1975) Intracranial arteriovenous malformations in childhood. Ann Neurol 3:338–343Google Scholar
  10. 10.
    Kretzschmar K, Grumme T, Kazner E (1980) Moglichkeiten und Grenzen der Computer-Tomographie und Angiographie in der Diagnostik cerebraler Gefäßmißbildungen. Radiologe 20:105–112Google Scholar
  11. 11.
    Long DL, Seljeskog EL, Chon SN, Frech LA (1974) Giant arteriovenous malformations of infancy and childhood. J Neurosurg 40:304–312Google Scholar
  12. 12.
    Merkes JH (1980) Textbook of child neurology, second edition. Lea and Febiger, Philadelphia, p 224Google Scholar
  13. 13.
    Orozco M, Trigueros F, Quintana F, Dierssen G (1978) Intracranial aneurysms in early childhood. Surg Neurol 9:247–252Google Scholar
  14. 14.
    Patel AN, Richardson AE (1971) Ruptured intracranial aneurysms in the first two decades of life. J Neurosurg 35:571–576Google Scholar
  15. 15.
    Paterson JH, McKissock W (1956) A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 79:233–266Google Scholar
  16. 16.
    Perret G, Nichioak H (1966) Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section IV: Arteriovenous malformations. J Neurosurg 25:467–490Google Scholar
  17. 17.
    Raimondi AJ, Cerullo LJ (1980) Vascular pathology. Pediatric cerebral angiography. Thieme, Stuttgart, pp 157–178Google Scholar
  18. 18.
    Sedzimir CB, Robinson JR (1973) Intracranial hemorrhage in children and adolescents. J Neurosurg 38:269–281Google Scholar
  19. 19.
    Takashima S, Becker LE (1980) Neuropathology of cerebral arteriovenous malformations in children. J Neurol Neurosurg Psychiatry 43:380–385Google Scholar
  20. 20.
    Thompson JR, Harwood-Nash DC, Fith CR (1973) Cerebral aneurysms in children. Am J Reentgenol 118:163–175Google Scholar

Copyright information

© Springer-Verlag 1983

Authors and Affiliations

  • U. Schauseil-Zipf
    • 1
    • 2
    • 3
    • 4
  • F. Thun
    • 1
    • 2
    • 3
    • 4
  • K. Kellermann
    • 1
    • 2
    • 3
    • 4
  • S. Mandl-Kramer
    • 1
    • 2
    • 3
    • 4
  • K. auf der Haar
    • 1
    • 2
    • 3
    • 4
  1. 1.EEG-LaborUniversitäts-Kinderklinik KölnKöln 41Federal Republik of Germany
  2. 2.NeuroradiologieRadiologisches Institut der Universität zu KölnKölnFederal Republik of Germany
  3. 3.Neurochirurgische UniversitätsklinikKölnFederal Republik of Germany
  4. 4.Kinderkrankenhaus der Stadt KölnKölnFederal Republik of Germany

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