gms | German Medical Science

Objective: Seizures before and after brain AVM treatment, intracerebral hemorrhage due a ruptured AVM in childhood are incriminating for brain and neurocognitve function with sequelaes for further social life. Long-term follow up data on pediatric brain AVMs are rare, making it difficult to compare and assess treatment risks and outcome. Our aim was to evaluate the long-term outcome in young patients with brain AVM, in terms of the ability to return back to school, work and social life.

Methods: In a prospective maintained database we have been analyzed young patients with complete follow up data referred to our institution between 1973 and 2012 with ruptured and unruptured brain AVM. We split two groups into ruptured AVMs (Group A) and unruptured AVMs (Group B) and compared treated and non-treated patients. Univariate and multivariate analysis were used, to assess predictive variables for outcome in cognitive function and social life.

Results: 45 children with a brain AVM were admitted and registered for the period of 1973 to 2012. A total of 29 young patients, median age 16 (range 2 to 20) years, were included in our study with a complete follow up data of over 282 patient-years (mean 10 years). In 18 (62.1) patients a ruptured AVM and in 11 (37.9) patients an unruptured AVM was found. 20 (69%) patients received a treatment (Group A 70% vs Group B 30%). Among the treatment methods microsurgery was most frequently used (Group A 33.3% vs. Group B 36.4%). In Group A 16 (88.9) patients returned back to work/school and in Group B 11 (100%) patients returned back to work/school. Favorable outcome was achieved in 13 patients with a ruptured AVM (Group A 72.2; 71.4% treated vs. 75% untreated) and in 11 (Group B; 100%) patients with an unruptured AVM.

Conclusion: Favorable outcome was achieved in the majority of patients. The rate of reintegration in social life was high in both groups. Neurological deficits can be well compensated in young age.