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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Cerebral arterio-venous malformations in the paediatric population: A single center experience

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  • Klaus-Peter Stein - Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany; KRH Klinikum Nordstadt, Klinik für Neurochirurgie, Hannover, Germany
  • Sophia Goericke - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
  • Neriman Oezkan - Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
  • I. Erol Sandalcioglu - KRH Klinikum Nordstadt, Klinik für Neurochirurgie, Hannover, Germany
  • Ulich Sure - Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
  • Oliver Mueller - Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.12.06

doi: 10.3205/16dgnc062, urn:nbn:de:0183-16dgnc0620

Published: June 8, 2016

© 2016 Stein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Cerebral arterio-venous malformations (AVM) are considered congenital lesions and represent an important cause of hemorrhagic stroke in children. The aim of this study is to analyze clinical and angiographic characteristics of AVMs in the subgroup of paediatric patients and their consequences for treatment.

Method: Between 1990-2015, 48 children with AVMs were treated in our institution. Clinical presentation, radiological data, treatment strategies and outcome were evaluated retrospectively.

Results: Of 46 consecutive patients with complete data, 18 were male and 28 female patients. Mean age was11.6 ± 4.3 years, ranging from 2 - 17 years. 36 patients (77%) presented with hemorrhage. Nine individuals with bleeding were admitted in poor clinical condition (mRS ≥3) and among these, 4 patients were in a comatose state. Location of AVMs was supratentorial in 35 cases (superficial N=25, deep N=10) and infratentorial in 11 cases (eloquence N=26, 63%). AVM size was predominantly small (N=27, 59%), and were therefore a Spetzler-Martin Grade I (3-tier) in the majority of patients (N=28, 61%). 41 patients (89%) received treatment of the AVM (endovascular, surgery, radiosurgery, combined treatment) and complete elimination could be achieved in 32 patients (78%), confirmed by post-op angiography (DSA) or MRI. 34 patients (83%) showed an excellent to favourable outcome (mRS ≤ 2) at last follow-up whereas 5 patients remained in poor clinical condition, mainly due to a poor initial clinical state. Two patients died.

Conclusions: In AVMs, particularly in young children, there is a high risk of presenting with a haemorrhage. The high number of hemorrhagic events in our cohort justifies a decisive approach to these lesions with a high rate of complete elimination and good clinical outcome.