Clinical, radiological profile and outcome in pediatric Spetzler-Martin grades I-III arteriovenous malformations.
Childs Nerv Syst
; 28(4): 593-8, 2012 Apr.
Article
em En
| MEDLINE
| ID: mdl-22270650
ABSTRACT
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
/
Malformações Arteriovenosas Intracranianas
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Childs Nerv Syst
Assunto da revista:
NEUROLOGIA
/
PEDIATRIA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Índia