Document Detail


Arteriovenous malformation-associated aneurysms in the pediatric population.
MedLine Citation:
PMID:  22208314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Conventional cerebral angiography and treatment for ruptured arteriovenous malformations (AVMs) in children are often performed in a delayed fashion. In adults, current literature suggests that AVM-associated aneurysms may be more likely to hemorrhage than isolated AVMs, which often leads to earlier angiography and endovascular treatment of associated aneurysms. The nature of AVM-associated aneurysms in the pediatric population is virtually unknown. In this report, the authors investigate the relationship of associated aneurysms in a large group of children with AVMs.
METHODS: Seventy-seven pediatric patients (≤ 21 years old) with AVMs were treated at the Columbia University Medical Center between 1991 and 2010. Medical records and imaging studies were retrospectively reviewed, and associated aneurysms were classified as arterial, intranidal, or venous in location. Clinical presentation and outcome variables were compared between children with and without AVM-associated aneurysms.
RESULTS: A total of 30 AVM-associated aneurysms were found in 22 children (29% incidence). Eleven were arterial, 9 intranidal, and 10 were venous in location. There was no significant difference in the rate of hemorrhage (p = 0.91) between children with isolated AVMs (35 of 55 [64%]) and children with AVM-associated aneurysms (13 of 22 [59%]). However, of the 11 children with AVM-associated aneurysms in an arterial location, 10 presented with hemorrhage (91%). An association with hemorrhage was significant in univariate analysis (p = 0.045) but not in multivariate analysis (p = 0.37).
CONCLUSIONS: Associated aneurysms are present in nearly a third of children with AVMs, and when arterially located, are more likely to present with hemorrhage. These data suggest that early angiography with endovascular treatment of arterial-based aneurysms in children with AVMs may be indicated.
Authors:
Richard C E Anderson; Michael M McDowell; Christopher P Kellner; Geoffrey Appelboom; Samuel S Bruce; Ivan S Kotchetkov; Raqeeb Haque; Neil A Feldstein; E Sander Connolly; Robert A Solomon; Philip M Meyers; Sean D Lavine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  9     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-02-13     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cerebral Angiography
Cerebral Hemorrhage / diagnosis,  epidemiology,  therapy
Child
Combined Modality Therapy
Cross-Sectional Studies
Embolization, Therapeutic
Female
Humans
Intracranial Aneurysm / diagnosis*,  epidemiology,  therapy
Intracranial Arteriovenous Malformations / diagnosis*,  epidemiology,  therapy
Male
Radiosurgery
Retrospective Studies
Secondary Prevention

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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