Skip to main content

Advertisement

SpringerLink
Log in

Endovascular management of arteriovenous malformations and other intracranial arteriovenous shunts in neonates, infants, and children

  • Special Annual Issue
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Purpose

We discuss the management of cerebral arteriovenous shunts in neonates, infants, and children, with emphasis on our experience with pediatric cerebral arteriovenous malformations (AVMs). The management of vein of Galen malformations is discussed in a separate chapter.

Methods

An all-inclusive retrospective chart review of the endovascular surgery operative record database at the Hyman Newman Institute for Neurology and Neurosurgery at Roosevelt Hospital in NYC was conducted. All consecutive pediatric patients (newborn to 18 years of age) with intracranial arteriovenous shunts who presented from January 1, 2004 to June 16, 2009 were included.

Results

A total of 151 consecutive pediatric patients with intracranial arteriovenous shunts were evaluated from the period of January 1, 2004 to June 16, 2009. This included 56 patients with vein of Galen malformations, 48 cerebral AVMs, 11 patients with pial arteriovenous fistulae, six patients with dural arteriovenous malformations, and 30 patients with mixed intracranial vascular malformations. Forty-four patients underwent a total of 163 endovascular embolizations. The complications rate for endovascular embolizations was 6.7% (11 in 163), 5.5% with temporary complications and 1.2% with permanent complications. The mortality rate for the group of patients (excluding patients with vein of Galen malformations) that underwent endovascular embolizations was 0.0%.

Conclusions

Careful clinical observation and timely intervention are important in the management of pediatric patients with intracranial arteriovenous shunts. Trans-arterial endovascular embolization with liquid embolic agents is the treatment of choice for safe stabilization and/or improvement of symptoms in the group of pediatric patients with intracranial arteriovenous malformations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Bhattacharya J, Luo C, Suh D, Alvarez H, Rodesch G, Lausjaunias P (2001) Wyburn–Mason or Bonnet–Dechaume–Blanc as cerebrofacial arteriovenous metameric syndrome (CAMS)—a new concept and new classification. Interv Neuroradiol 7:5–17

    CAS  PubMed  Google Scholar 

  2. Hladky J, Lejeune J, Blond S, Pruvo J, Dhellemmes P (1994) Cerebral arteriovenous malformations in children: report on 62 cases. Childs Nerv Syst 10:328–333

    Article  CAS  PubMed  Google Scholar 

  3. Katsaridis V, Papagiannaki C, Aimar E (2008) Curative embolization of cerebral arteriovenous malformations (AVM) with Onyx in 101 patients. Neuroradiology 50(7):589–597

    Article  PubMed  Google Scholar 

  4. Lausjaunias P, Ter Brugge KG, Berenstein A (2006) Introductions and General Comments Regarding Pediatric Intracranial Arteriovenous Shunts. Surgical Neuroangiography. Volume 3. Second Edition. Berlin

  5. Lausjaunias P, Ter Brugge KG, Berenstein A (2004) Technical Aspects of Surginal Neuroangiography. Surgical Neuroangiography. Volume 2.2. Second Edition. Berlin

  6. Mahadevan J, Ozanne A, Yoshida WY, Alvarez H, Rodesch G (2004) Hereditary haemorrhagic telangiectasia cerebrospinal localization in adults and children. Review of 39 cases. Interv Neuroraidol 10:27–35

    CAS  Google Scholar 

  7. Ozanne A, Alvarez H, Krings T, Lausjaunias P (2007) Pediatric neurovascular malformations: vein of Galen arteriovenous malformations (VGAM), pial arteriovenous malformations (pial AVM), dural sinus malformations (DSM). J Neuroradiol 34(3):145–166

    Article  CAS  PubMed  Google Scholar 

  8. Pan D, Kuo Y, Guo W, Chung W, Wu H, Liu K, Chang Y, Wang L, Wong T (2008) Gamma knife surgery for cerebral arteriovenous malformations in children: a 13-year experience. J Neurosurg Pediatr 2(3):229

    Article  Google Scholar 

  9. Sanchez-Mejia R, Chennupati S, Gupta N, Fullerton H, Young W, Lawton M (2006) Superior outcomes in children compared with adults after microsurgical resection of brain arteriovenous malformations. J Neurosurg 105(2):82–87

    PubMed  Google Scholar 

  10. Shin M, Kawamoto S, Kurita H, Tago M, Sasaki T, Morita A, Ueki K, Kirino T (2002) Retrospective analysis of a 10-year experience of stereotactic radio surgery for arteriovenous malformations in children and adolescents. J Neurosurg 97:779–784

    Article  PubMed  Google Scholar 

  11. Smith L, Barth P, Stam F, Valk J (1981) Congenital multiple angiomatosis with brain involvement. Childs Brain 8:461–467

    Google Scholar 

  12. Spetzler R, Martin N (1986) A proposed grading system for arteriovenous malformations. J Neurosurg 65(4):476–483

    Article  CAS  PubMed  Google Scholar 

  13. Willinsky R, Lausjaunias P, Ter Brugge K, Burrows P (1990) Multiple cerebral arteriovenous malformations (AVMs): review of our experience from 203 patients with cerebral vascular lesions. Neuroradiology 32:207–210

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Endovascular Surgery, Roosevelt Hospital, 1000 10th Ave, Suite 10-G, New York, NY, 10019, USA

    Alejandro Berenstein, Rafael Ortiz, Yasunari Niimi, Lucas Elijovich, Johanna Fifi & Mary Madrid

  2. Pediatric Neurosurgery, Roosevelt Hospital, 1000 10th Ave, Suite 10-G, New York, NY, 10019, USA

    Saadi Ghatan

  3. Pediatric Neurology, Roosevelt Hospital, 1000 10th Ave, Suite 10-G, New York, NY, 10019, USA

    Walter Molofsky

Authors
  1. Alejandro Berenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rafael Ortiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasunari Niimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lucas Elijovich
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Johanna Fifi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mary Madrid
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Saadi Ghatan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Walter Molofsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rafael Ortiz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berenstein, A., Ortiz, R., Niimi, Y. et al. Endovascular management of arteriovenous malformations and other intracranial arteriovenous shunts in neonates, infants, and children. Childs Nerv Syst 26, 1345–1358 (2010). https://doi.org/10.1007/s00381-010-1206-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-010-1206-y

Keywords

Search

Navigation