| Clinical, radiological profile and outcome in pediatric Spetzler-Martin grades I-III arteriovenous malformations. | |
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MedLine Citation:
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PMID: 22270650 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Treatment of pediatric arteriovenous malformations (AVMs) is always a challenge considering their hemorrhagic presentation, associated morbidity and mortality, and the potential long life span of these children. Spetzler-Martin grades I-III are the grey zones as far as the treatment options are concerned. With a generous multimodality approach, one can reduce the morbidity and mortality to a considerable extent. OBJECTIVE: To analyze the demographic and clinico-radiological profile of pediatric intracranial AVMs belonging to Spetzler-Martin grades I-III and their outcome following microsurgical excision. METHODS: Pediatric patients (≤18 years of age) from a period of January 2001-January 2011 were included in the study. Patients with associated aneurysms or tumors were excluded from the study. Post-operative DSA/CT angiography was done within 6 weeks after surgery. Outcome was analyzed in terms of neurological improvement according to Medical Research Council Grade (MRC), obliteration of the AVM in post-operative angiography and Modified Rankin score. Outcome based on Modified Rankin score was favorable with a score of 0-2 and unfavorable when the score was 3-6. RESULTS: A total of 36 patients with a mean follow-up of 12.75 months were identified. Thirty-one patients (86.1%) presented with hemorrhage while only 15 (41.6%) presented with seizures. There were 25 (69.4%) males and 11 (30.6%) females. Spetzler-Martin grade was grade I in six patients, grade II in 20 patients, and grade III in ten patients. All patients underwent surgical excision of the AVMs and post-operative angiography showed a 100% obliteration rate. There was a favorable outcome in 86.1% of the patients according to modified Rankin score. CONCLUSION: The aim of treating a pediatric AVM should be complete obliteration of the AVM considering the high risk of hemorrhage and the morbidity and mortality associated with hemorrhage. With careful planning and adopting a multimodality treatment, complete obliteration can definitely be achieved. |
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Authors:
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Anup P Nair; Raj Kumar; Anant Mehrotra; A K Srivastava; Rabi Narayan Sahu; Prakash Nair |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-21 |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: - ISSN: 1433-0350 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, 226014, India. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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