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Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations

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Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations. / Reitz, Matthias; von Spreckelsen, Niklas; Vettorazzi, Eik; Burkhardt, Till; Grzyska, Ulrich; Fiehler, Jens; Schmidt, Nils Ole; Westphal, Manfred; Regelsberger, Jan.

In: WORLD NEUROSURG, Vol. 89, 17.02.2016, p. 540-51.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Reitz, M, von Spreckelsen, N, Vettorazzi, E, Burkhardt, T, Grzyska, U, Fiehler, J, Schmidt, NO, Westphal, M & Regelsberger, J 2016, 'Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations', WORLD NEUROSURG, vol. 89, pp. 540-51. https://doi.org/10.1016/j.wneu.2016.02.050

APA

Reitz, M., von Spreckelsen, N., Vettorazzi, E., Burkhardt, T., Grzyska, U., Fiehler, J., Schmidt, N. O., Westphal, M., & Regelsberger, J. (2016). Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations. WORLD NEUROSURG, 89, 540-51. https://doi.org/10.1016/j.wneu.2016.02.050

Vancouver

Reitz M, von Spreckelsen N, Vettorazzi E, Burkhardt T, Grzyska U, Fiehler J et al. Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations. WORLD NEUROSURG. 2016 Feb 17;89:540-51. https://doi.org/10.1016/j.wneu.2016.02.050

Bibtex

@article{5d2f778468784a799e827881e551c13f,
title = "Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations",
abstract = "BACKGROUND: Intracranial arteriovenous malformation (AVM) in children is a rare diagnosis. Little is known about factors determining AVM rupture and appropriate treatment strategies to prevent hemorrhage and associated disability. Available data suggest that children are subject to an increased risk for AVM rupture compared to adults.METHODS: In 46 pediatric AVM patients, demographic factors, clinical presentation, angioarchitectural features, treatment regimens as well as clinical and radiological outcomes were retrospectively analyzed. First-line treatment option was the microsurgical resection of the pathology, with or without preoperative embolization.RESULTS: 24 males (52.2%) and 22 females (47.8%) with a mean age on admission of 12.4 years (4-18 years) were included. Mean follow-up was 4 years (median 1.5; range 0.1-16.4). 31 children presented with intracerebral hemorrhage (67.4%). Small AVMs (<3 cm) ruptured in 83.3% (n=25) and were shown to be more prone to hemorrhage than larger ones (p<.01). Small AVM size (p<.01; OR .12; 95% CI .02, .59) and exclusive deep venous drainage (p<.01; OR 29.74; 95% CI 2.45, 4445.34) were independent risk factors for hemorrhage in the presented cohort. Good long-term outcome was associated with a high score on the Glasgow Coma Scale (GCS) on admittance (p<.05; OR .148; 95% CI .03, .73;).CONCLUSION: Two-thirds of children with AVM are admitted with intracerebral hemorrhage. Microsurgical resection was successful as confirmed by radiological studies in 95% and 79.5% of patients presented in a good clinical condition on follow-up (mRS 0 or 1). Microsurgical treatment is recommended if the lesion is accessible and angioarchitectural risk factors favor definitive treatment.",
author = "Matthias Reitz and {von Spreckelsen}, Niklas and Eik Vettorazzi and Till Burkhardt and Ulrich Grzyska and Jens Fiehler and Schmidt, {Nils Ole} and Manfred Westphal and Jan Regelsberger",
note = "Copyright {\textcopyright} 2015 Elsevier Inc. All rights reserved.",
year = "2016",
month = feb,
day = "17",
doi = "10.1016/j.wneu.2016.02.050",
language = "English",
volume = "89",
pages = "540--51",
journal = "WORLD NEUROSURG",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

RIS

TY - JOUR

T1 - Angioarchitectural risk factors for hemorrhage and clinical long-term outcome in pediatric patients with cerebral arteriovenous malformations

AU - Reitz, Matthias

AU - von Spreckelsen, Niklas

AU - Vettorazzi, Eik

AU - Burkhardt, Till

AU - Grzyska, Ulrich

AU - Fiehler, Jens

AU - Schmidt, Nils Ole

AU - Westphal, Manfred

AU - Regelsberger, Jan

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2016/2/17

Y1 - 2016/2/17

N2 - BACKGROUND: Intracranial arteriovenous malformation (AVM) in children is a rare diagnosis. Little is known about factors determining AVM rupture and appropriate treatment strategies to prevent hemorrhage and associated disability. Available data suggest that children are subject to an increased risk for AVM rupture compared to adults.METHODS: In 46 pediatric AVM patients, demographic factors, clinical presentation, angioarchitectural features, treatment regimens as well as clinical and radiological outcomes were retrospectively analyzed. First-line treatment option was the microsurgical resection of the pathology, with or without preoperative embolization.RESULTS: 24 males (52.2%) and 22 females (47.8%) with a mean age on admission of 12.4 years (4-18 years) were included. Mean follow-up was 4 years (median 1.5; range 0.1-16.4). 31 children presented with intracerebral hemorrhage (67.4%). Small AVMs (<3 cm) ruptured in 83.3% (n=25) and were shown to be more prone to hemorrhage than larger ones (p<.01). Small AVM size (p<.01; OR .12; 95% CI .02, .59) and exclusive deep venous drainage (p<.01; OR 29.74; 95% CI 2.45, 4445.34) were independent risk factors for hemorrhage in the presented cohort. Good long-term outcome was associated with a high score on the Glasgow Coma Scale (GCS) on admittance (p<.05; OR .148; 95% CI .03, .73;).CONCLUSION: Two-thirds of children with AVM are admitted with intracerebral hemorrhage. Microsurgical resection was successful as confirmed by radiological studies in 95% and 79.5% of patients presented in a good clinical condition on follow-up (mRS 0 or 1). Microsurgical treatment is recommended if the lesion is accessible and angioarchitectural risk factors favor definitive treatment.

AB - BACKGROUND: Intracranial arteriovenous malformation (AVM) in children is a rare diagnosis. Little is known about factors determining AVM rupture and appropriate treatment strategies to prevent hemorrhage and associated disability. Available data suggest that children are subject to an increased risk for AVM rupture compared to adults.METHODS: In 46 pediatric AVM patients, demographic factors, clinical presentation, angioarchitectural features, treatment regimens as well as clinical and radiological outcomes were retrospectively analyzed. First-line treatment option was the microsurgical resection of the pathology, with or without preoperative embolization.RESULTS: 24 males (52.2%) and 22 females (47.8%) with a mean age on admission of 12.4 years (4-18 years) were included. Mean follow-up was 4 years (median 1.5; range 0.1-16.4). 31 children presented with intracerebral hemorrhage (67.4%). Small AVMs (<3 cm) ruptured in 83.3% (n=25) and were shown to be more prone to hemorrhage than larger ones (p<.01). Small AVM size (p<.01; OR .12; 95% CI .02, .59) and exclusive deep venous drainage (p<.01; OR 29.74; 95% CI 2.45, 4445.34) were independent risk factors for hemorrhage in the presented cohort. Good long-term outcome was associated with a high score on the Glasgow Coma Scale (GCS) on admittance (p<.05; OR .148; 95% CI .03, .73;).CONCLUSION: Two-thirds of children with AVM are admitted with intracerebral hemorrhage. Microsurgical resection was successful as confirmed by radiological studies in 95% and 79.5% of patients presented in a good clinical condition on follow-up (mRS 0 or 1). Microsurgical treatment is recommended if the lesion is accessible and angioarchitectural risk factors favor definitive treatment.

U2 - 10.1016/j.wneu.2016.02.050

DO - 10.1016/j.wneu.2016.02.050

M3 - SCORING: Journal article

C2 - 26898497

VL - 89

SP - 540

EP - 551

JO - WORLD NEUROSURG

JF - WORLD NEUROSURG

SN - 1878-8750

ER -