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Surgical and Endovascular Treatment of Pediatric Spinal Arteriovenous Malformations.
MedLine Citation:
PMID:  22120563     Owner:  NLM     Status:  Publisher    
BACKGROUND: Pediatric spinal arteriovenous malformations (AVMs) are rare and complex lesions to treat. There are few reports of the endovascular and microsurgical treatment of these lesions in the pediatric population, and the treatment outcomes of these patients are not well described. OBJECTIVE: To study the clinical and radiographic outcomes of spinal AVMs in pediatric patients treated via endovascular and microsurgical modalities. METHODS: We identified 9 children (5 boys, 4 girls; average age 11 years, range 3-17 years) treated for spinal AVMs between 1998 and 2010. Their charts were reviewed. RESULTS: Spinal AVMs most frequently involved the thoracic spinal cord. Four patients had associated Klippel-Trènaunay-Weber (KTW) syndrome and one had hereditary hemorrhagic telangiectasia. There were 2 intramedullary, 4 conus medullaris, and 3 mixed extradural-intradural lesions. The most common presenting signs and symptoms were subarachnoid hemorrhage (SAH, n=3) and paraparesis (n=5). Endovascular intervention was utilized exclusively in 2, and combined endovascular and microsurgical intervention was used in 4 cases. Surgery was the sole treatment in 3 cases with excellent results. There were two treatment-related complications: one case of SAH and one case of scrotal swelling. The mean follow up was 28.5 months and the median 8 months (range 1-65 months). The mean pretreatment WHO/Zubrod score was 2.4 (range 1-4), and the mean posttreatment score was 1.4 (range 0-4). One patient (11%) had a recurrence. CONCLUSIONS: Pediatric spinal AVMs require complex combined microsurgical and endovascular techniques to achieve favorable outcomes.
M Yashar S Kalani; Azam Ahmed; Nikolay L Martirosyan; Katharine Cronk; Karam Moon; Felipe C Albuquerque; Cameron G McDougall; Robert F Spetzler; Ruth E Bristol
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-1
Journal Detail:
Title:  World neurosurgery     Volume:  -     ISSN:  1878-8750     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
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