Recurrence of cerebral arteriovenous malformations in children: report of two cases and review of the literature
| Autor: | John M. Tew, Sumeer Sathi, John S. Myseros, Kerry R. Crone, Norberto Andaluz |
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| Rok vydání: | 2003 |
| Předmět: |
Intracranial Arteriovenous Malformations
Male medicine.medical_specialty Time Factors Adolescent Complete resection Recurrence Medicine Humans Treatment Failure Child Retrospective Studies Postoperative Care Retrospective review medicine.diagnostic_test business.industry Vascular disease Infant Newborn Arteriovenous malformation medicine.disease Surgery Cerebral arteriovenous malformations Cerebral Angiography Treatment success El Niño Child Preschool Angiography Practice Guidelines as Topic Female Neurology (clinical) Radiology business Follow-Up Studies |
| Zdroj: | Surgical neurology. 62(4) |
| ISSN: | 0090-3019 |
| Popis: | BACKGROUND Angiography is considered the standard to assess the treatment success of cerebral arteriovenous malformations (AVMs). When postoperative angiograms show neither residual nidus nor early draining veins, patients are considered cured, and the risks of hemorrhage are eliminated. However, this notion is challenged by the development of recurrent AVMs in children. In our report, 2 children developed recurrent AVMs after undergoing complete resection, which was documented by postoperative angiography. We review other similar cases reported in the literature to help establish guidelines for postoperative monitoring. METHODS In this retrospective review, 36 children underwent complete surgical resection of cerebral AVMs that were documented by intra- or postoperative angiography. After a follow-up period ranging from 1 to 17 years, rates of recurrence were assessed. RESULTS Although angiographic documentation showed complete resection, 2 children developed recurrences 3 and 5 years later. Among these 36 children, the recurrence rate was 5.5% at follow-up (mean 9 years). CONCLUSIONS Based on our data and review of the literature, intra- or early postoperative angiography is essential to exclude the presence of a residual nidus but does not ensure cure of the AVMs in children. If postoperative angiographic scans are obtained too early, postoperative changes may prevent the detection of a residual nidus. Therefore, we recommend that angiographic scans be obtained intraoperatively or early postoperatively to document complete resection and again at 1 and 5 years after surgical resection. |
| Databáze: | OpenAIRE |
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