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Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations.

Publication ,  Journal Article
Oulasvirta, E; Koroknay-Pál, P; Hafez, A; Elseoud, AA; Lehto, H; Laakso, A
Published in: Neurosurgery
January 1, 2019

BACKGROUND: Population-based long-term data on pediatric patients with cerebral arteriovenous malformations (AVMs) are limited. OBJECTIVE: To clarify the characteristics and long-term outcome of pediatric patients with AVM. METHODS: A retrospective analysis was performed on 805 consecutive brain AVM patients admitted to a single center between 1942 and 2014. The patients were defined as children if they were under 18 yr at admission. Children were compared to an adult cohort. Changing patterns of presentation were also analyzed by decades of admission. RESULTS: The patients comprised 127 children with a mean age of 12 yr. The mean follow-up time was 21 yr (range 0-62). Children presented more often with intracerebral hemorrhage (ICH) but less often with epilepsy than adults. Basal ganglia, cerebellar, and posterior paracallosal AVMs were more common in pediatric than in adult patients. Frontal and temporal AVMs, in contrast, were more common in adult than in pediatric patients. As the number of incidentally and epilepsy-diagnosed AVMs increased, ICH rates dropped in both cohorts. In total, 22 (82%) pediatric and 108 (39%) adult deaths were assessed as AVM related. After multivariate analysis, small AVM size and surgical treatment correlated with a favorable long-term outcome. CONCLUSION: Hemorrhagic presentation was more common in children than in adults. This was also reflected as lower prevalence of epileptic presentation in the pediatric cohort. Lobar and cortical AVM locations were less frequent, whereas deep and cerebellar AVMs were more common in children. Hemorrhagic presentation correlated negatively with incidentally and epilepsy-diagnosed AVMs. In children, AVM was a major cause of death, but in adults, other factors contributed more commonly to mortality.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

January 1, 2019

Volume

84

Issue

1

Start / End Page

151 / 159

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Intracranial Arteriovenous Malformations
  • Infant, Newborn
  • Infant
  • Humans
  • Child, Preschool
  • Child
 

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Oulasvirta, E., Koroknay-Pál, P., Hafez, A., Elseoud, A. A., Lehto, H., & Laakso, A. (2019). Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations. Neurosurgery, 84(1), 151–159. https://doi.org/10.1093/neuros/nyy008
Oulasvirta, Elias, Päivi Koroknay-Pál, Ahmad Hafez, Ahmed Abou Elseoud, Hanna Lehto, and Aki Laakso. “Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations.Neurosurgery 84, no. 1 (January 1, 2019): 151–59. https://doi.org/10.1093/neuros/nyy008.
Oulasvirta E, Koroknay-Pál P, Hafez A, Elseoud AA, Lehto H, Laakso A. Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations. Neurosurgery. 2019 Jan 1;84(1):151–9.
Oulasvirta, Elias, et al. “Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations.Neurosurgery, vol. 84, no. 1, Jan. 2019, pp. 151–59. Pubmed, doi:10.1093/neuros/nyy008.
Oulasvirta E, Koroknay-Pál P, Hafez A, Elseoud AA, Lehto H, Laakso A. Characteristics and Long-Term Outcome of 127 Children With Cerebral Arteriovenous Malformations. Neurosurgery. 2019 Jan 1;84(1):151–159.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

January 1, 2019

Volume

84

Issue

1

Start / End Page

151 / 159

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Intracranial Arteriovenous Malformations
  • Infant, Newborn
  • Infant
  • Humans
  • Child, Preschool
  • Child