Abstract
Purpose
Cerebral arteriovenous malformations (AVM) are uncommon lesions. They are most often presented in childhood as intracranial hemorrhage. The aim of this report is to present the use of transcranial color-coded duplex sonography (TCCS) in detection of AVMs in children suffering headache.
Methods
This report describes five pediatric patients with headache and cerebral AVM which were initially discovered by TCCS. Diagnosis was confirmed by magnetic resonance imaging and digital subtraction angiography.
Results
In all patients, TCCS showed saccular enlargement of the vessels with a multicolored pattern corresponding to the different directions of blood flow. Spectral analysis showed significantly high flow systolic and diastolic velocities and low resistance index.
Conclusions
In this report, we describe TCCS as a valuable non-invasive, harmless, low-cost, widely available method for the detection and follow-up of hemodynamic changes of AVMs in children with headache, before and after treatment.
This is a preview of subscription content, log in via an institution to check access.
References
Tong X, Wu J, Lin F, Cao Y, Zhao Y, Ning B, Zhao B, Wang L, Zhang S, Wang S, Zhao J (2016) The effect of age, sex and lesion location on initial presentation in patients with brain arteriovenous malformation. World Neurosurg 87:598–606. https://doi.org/10.1016/j.wneu.2015.10.060
Ding D, Starke RM, Kano H, Mathieu D, Huang PP, Feliciano C, Rodriguez-Mercado R, Almodovar L, Grills IS, Silva D, Abbassy M, Missios S, Kondziolka D, Barnett GH, Dade Lunsford L, Sheehan JP (2017) International multicenter cohort study of pediatric brain arteriovenous malformations. Part 1: predictors of hemorrhagic presentation. J Neurosurg Pediatr 19(2):127–135. https://doi.org/10.3171/2016.9.PEDS16283
Gross BA, Storey A, Orbach DB, Scott RM, Smith ER (2015) Microsurgical treatment of arteriovenous malformations in children: the Boston Children’s Hospital experience. J Neurosurg Pediatr 15(1):71–77. https://doi.org/10.3171/2014.9.PEDS146
Gross BA, Scott RM, Smith ER (2014) Management of brain arteriovenous malformations. Lancet 383(9929):1635. https://doi.org/10.1016/S0140-6736(14)60785-6
Becker GM, Winkler J, Hoffman E, Bogdahn U (1990) Imaging of cerebral arterio-venous malformations by transcranial colour-coded real-time sonography. Neuroradiology 32(4):280–288. https://doi.org/10.1007/BF00593046
Schöning M, Niemann G, Hartig B (1996) Transcranial color duplex sonography of basal cerebral arteries: reference data of flow velocities from childhood to adulthood. Neuropediatrics 27(05):249–255. https://doi.org/10.1055/s-2007-973773
Wöber-Bingöl C (2013) Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep 17(6):341. https://doi.org/10.1007/s11916-013-0341-z
Hoh BL, Ogilvy CS, Butler WE, Loeffler JS, Putman CM, Chapman PH (2000) Multimodality treatment of nongalenic arteriovenous malformations in pediatric patients. Neurosurgery 47(2):346–357. https://doi.org/10.1097/00006123-200008000-00015
Bartels E (2005) Evaluation of arteriovenous malformations (AVMs) with transcranial color-coded duplex sonography: does the location of an AVM influence its sonographic detection? J Ultrasound Med 24(11):1511–1517. https://doi.org/10.7863/jum.2005.24.11.1511
Uggowitzer MM, Kugler C, Riccabona M, Klein GE, Leber K, Simbrunner J, Quehenberger F (1999) Cerebral arteriovenous malformations: diagnostic value of echo-enhanced transcranial Doppler sonography compared with angiography. Am J Neuroradiol 20:101–116
Meila D, Lisseck K, Jacobs C, Lanfermann H, Brassel F, Feldkamp A (2015) Cranial Doppler ultrasound in Vein of Galen malformation. Neuroradiology 57(2):211–219. https://doi.org/10.1007/s00234-014-1455-7
Roser T, Bonfert M, Ebinger F, Blankenburg M, Ertl-Wagner B, Heinen F (2013) Primary versus secondary headache in children: a frequent diagnostic challenge in clinical routine. Neuropediatrics 44(1):34–39. https://doi.org/10.1055/s-0032-1332743
Shtaya A, Millar J, Sparrow O (2017) Multimodality management and outcomes of brain arterio-venous malformations (AVMs) in children: personal experience and review of the literature, with specific emphasis on age at first AVM bleed. Childs Nerv Syst 33(4):573–581. https://doi.org/10.1007/s00381-017-3383-4
Aboukais R, Vinchon M, Quidet M, Bourgeois P, Leclerc X, Lejeune JP (2017) Reappearance of arteriovenous malformations after complete resection of ruptured arteriovenous malformations: true recurrence or false-negative early postoperative imaging result? J Neurosurg 126(4):1088–1093. https://doi.org/10.3171/2016.3.JNS152846
Yeo JJ, Low SY, Seow WT, Low DC (2015) Pediatric de novo cerebral AVM—report of two cases and review of literature. Child Nerv Syst 31(4):609–614. https://doi.org/10.1007/s00381-014-2609-y
Acknowledgements
The authors would like to thank for help in diagnostics and treatment of our patients: Prof. Marko Rados, MD, PhD, Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Croatia; Zdravko Heinrich, MD, Department of Neurosurgery, University Hospital Centre Zagreb, Croatia; Prof. Hortensia Alvarez, MD, PhD, UNC Imaging and Radiology, UNC Hospitals Hillsborough Campus, Hillsborough, North Carolina (formerly employed at: Centre Hospitalier Universitaire de Bicêtre, Paris).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Rights and permissions
About this article
Cite this article
Duranovic, V., Vulin, K., Dakovic, I. et al. The characteristics of transcranial color-coded duplex sonography in children with cerebral arteriovenous malformation presenting with headache. Childs Nerv Syst 34, 199–203 (2018). https://doi.org/10.1007/s00381-017-3692-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-017-3692-7