Unruptured cerebral arteriovenous malformation ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Unruptured cerebral arteriovenous malformation in children: Outcome in treated and untreated patients.
Author(s) :
Vinchon, Matthieu [Auteur]
Toubol, A. [Auteur]
Karnoub, Mélodie-Anne [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Aboukais, Rabih [Auteur]
Leclerc, Xavier [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Reyns, Nicolas [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Toubol, A. [Auteur]
Karnoub, Mélodie-Anne [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Aboukais, Rabih [Auteur]
Leclerc, Xavier [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Reyns, Nicolas [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Journal title :
Neurochirurgie
Abbreviated title :
Neurochirurgie
Volume number :
69
Pages :
101440
Publication date :
2023-04-18
ISSN :
1773-0619
English keyword(s) :
Cerebral arteriovenous malformation
Pediatric AVM
ARUBA study
Natural history
Microsurgery
Embolization
Radiosurgery
Pediatric AVM
ARUBA study
Natural history
Microsurgery
Embolization
Radiosurgery
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
The management of unruptured cerebral arteriovenous malformation (URCAVM) is highly controversial; however, data regarding URCAVM in children are scarce.
Material and methods
We retrospectively reviewed ...
Show more >Background The management of unruptured cerebral arteriovenous malformation (URCAVM) is highly controversial; however, data regarding URCAVM in children are scarce. Material and methods We retrospectively reviewed consecutive children followed for URCAVM in our department between 2001 and 2021. Results Out of 36 patients, 12 were initially managed by observation, and 24 underwent first-line treatment: 8 by microsurgery, 10 by radiosurgery, 2 by embolization, and 4 by combined treatment. Mean follow-up of the whole group was 63 months. Complete cure of the malformation was obtained in 14 patients (58%) in the treatment group: 8/8 in the microsurgery group, 5/10 in the radiosurgery group, 1/4 in the combined treatment group, and none in the embolization group. Two of the initially non-treated patients presented cerebral hemorrhage, with significant neurological consequences. In the treatment group, 5 patients presented new neurological deficits, only 1 of which, however, was functionally significant. Headache improved in 11 cases, mostly in the treatment group. Overall, 6 patients in the treatment group became asymptomatic, versus none in the observation group. Conclusions The treatment of URCAVM is a reasonable option in many pediatric cases, considering the cumulative risk of cerebral hemorrhage during the child's lifetime, as well as the symptoms specific to URCAVM. Microsurgery, when feasible, offers the best functional results and control of the AVM; however, the risk–benefit ratio should be weighed on a case-by-case basis. More studies will be needed to inform treatment decisions in pediatric URCAVM.Show less >
Show more >Background The management of unruptured cerebral arteriovenous malformation (URCAVM) is highly controversial; however, data regarding URCAVM in children are scarce. Material and methods We retrospectively reviewed consecutive children followed for URCAVM in our department between 2001 and 2021. Results Out of 36 patients, 12 were initially managed by observation, and 24 underwent first-line treatment: 8 by microsurgery, 10 by radiosurgery, 2 by embolization, and 4 by combined treatment. Mean follow-up of the whole group was 63 months. Complete cure of the malformation was obtained in 14 patients (58%) in the treatment group: 8/8 in the microsurgery group, 5/10 in the radiosurgery group, 1/4 in the combined treatment group, and none in the embolization group. Two of the initially non-treated patients presented cerebral hemorrhage, with significant neurological consequences. In the treatment group, 5 patients presented new neurological deficits, only 1 of which, however, was functionally significant. Headache improved in 11 cases, mostly in the treatment group. Overall, 6 patients in the treatment group became asymptomatic, versus none in the observation group. Conclusions The treatment of URCAVM is a reasonable option in many pediatric cases, considering the cumulative risk of cerebral hemorrhage during the child's lifetime, as well as the symptoms specific to URCAVM. Microsurgery, when feasible, offers the best functional results and control of the AVM; however, the risk–benefit ratio should be weighed on a case-by-case basis. More studies will be needed to inform treatment decisions in pediatric URCAVM.Show less >
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Collections :
Submission date :
2023-12-13T03:46:10Z
2024-01-22T12:50:32Z
2024-01-22T12:50:32Z