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Pediatric Intracranial Dural Arteriovenous Fistulas: Review of the Literature and Case Report

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Intracranial and Spinal Dural Arteriovenous Fistulas

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Abstract

Pediatric intracranial dural arteriovenous fistulas (dAVFs) are a group of rare pathological vascular malformations. dAVFs account for 5.7–10% of all intracranial vascular malformations in pediatric population. Pediatric dAVFs have a more aggressive clinical course compared with adult dAVFs. Pediatric dAVFs have been classified into three types: dural sinus malformation (DSM), infantile dAVF and adult-type dAVF. Most pediatric dAVFs tend to be considered congenital. The presentation of pediatric dAVFs depends on the hemodynamic symptoms including high-flow steal, venous drainage occlusion and mass effects. Pediatric dAVFs may be dormant for a long time prior to the occurrence of progressive symptoms. A multimodal imaging approach is essential in the evaluation of the venous system. When a vascular malformation is suspected, special imaging studies are necessary for verification of intracranial hemorrhage, identification of zones of venous infarction and ischemia. The goal of treatment of dAVFs is to prevent the occurrence of intracranial hemorrhage or neurological deficits. The aim is to occlude the fistulous communication and arterial feeders. The treatment strategies currently available are endovascular embolization, surgery, stereotactic radiosurgery, or a combination of these. Pediatric dAVFs can have an unsatisfactory prognosis, even with timely and appropriate treatment; however, with the ongoing development of embolization materials and techniques, improved treatments and prognoses are increasingly likely. The extent of brain damage acquired during the existence of functioning dAVF, as well as the need for surgical treatment of hydrocephalus, are among the factors that have to be considered to evaluate long-term results of treatment and prognosis.

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Authors and Affiliations

  1. N.N. Burdenko National Medical Research Center for Neurosurgery, Moscow, Russia

    Sergey Yakovlev, Nikolay Kobiakov & Anna Shulgina

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  1. Sergey Yakovlev
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  2. Nikolay Kobiakov
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  3. Anna Shulgina
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Correspondence to Anna Shulgina .

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  1. Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    Xianli Lv

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Yakovlev, S., Kobiakov, N., Shulgina, A. (2022). Pediatric Intracranial Dural Arteriovenous Fistulas: Review of the Literature and Case Report. In: Lv, X. (eds) Intracranial and Spinal Dural Arteriovenous Fistulas. Springer, Singapore. https://doi.org/10.1007/978-981-19-5767-3_2

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  • DOI: https://doi.org/10.1007/978-981-19-5767-3_2

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