caa a22 4500 463179021 CHVBK 20180406164833.0 cr unu---uuuuu 170326e20070101xx s 000 0 eng 10.1007/s00381-006-0245-x doi (NATIONALLICENCE)springer-10.1007/s00381-006-0245-x Pediatric arteriovenous malformations: a 15-year experience with an emphasis on residual and recurrent lesions [Elektronische Daten] [Paul Klimo Jr., Ganesh Rao, Douglas Brockmeyer] Object: Pediatric arteriovenous malformations (AVMs) are generally treated with microsurgical resection to achieve complete obliteration. We review our experience treating AVMs in children, particularly those with residual or recurrent lesions. Methods: The records of 39 patients with AVMs (25 girls: 14 boys; average age 10.3years) treated during a 15-year period were reviewed (mean follow-up 30months). Three primary outcomes were analyzed: AVM obliteration by last follow-up, residual on postoperative angiograms and recurrence after angiographic "cure.” Results: Most children (57%) presented with spontaneous intracerebral hemorrhage, the average nidus size was 3.4cm, and the modal Spetzler-Martin grade was 2. AVMs were classified as compact (82%) or diffuse (18%). Most patients (90%) underwent surgery as their primary treatment. The immediate obliteration rate was 76% and the overall, long-term obliteration rate was 89%. Nine (23%) patients had residual nidus after initial treatment; five of these underwent further treatment that obliterated their lesion. Five (13%) patients developed recurrence within 6years, including one patient with two recurrences. Three were successfully treated with a repeat resection. Patients with diffuse-type AVMs were at greater risk of having a persistent lesion (40%), residual lesion (44%), or recurrence (80%) at last follow-up. Conclusion: Most pediatric AVMs can be successfully treated with microsurgical resection. Endovascular treatment is reserved primarily as a preoperative adjunct and stereotactic radiosurgery for inoperable AVMs. Patients may develop recurrences years after their original treatment. Patients with diffuse-type AVMs were less likely to be cured and more likely to have a residual or a recurrence. Springer-Verlag, 2006 Pediatric nationallicence Arteriovenous malformations nationallicence Recurrence nationallicence Residual nationallicence Diffuse nationallicence Obliteration nationallicence Klimo Jr. Paul Department of Neurosurgery, University of Utah, Primary Children's Medical Center, 100 N. Medical Drive, 84113, Salt Lake City, UT, USA aut Rao Ganesh Department of Neurosurgery, University of Utah, Primary Children's Medical Center, 100 N. Medical Drive, 84113, Salt Lake City, UT, USA aut Brockmeyer Douglas Department of Neurosurgery, University of Utah, Primary Children's Medical Center, 100 N. Medical Drive, 84113, Salt Lake City, UT, USA aut Child's Nervous System Springer-Verlag 23/1(2007-01-01), 31-37 0256-7040 23:1<31 2007 23 381 https://doi.org/10.1007/s00381-006-0245-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-006-0245-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Klimo Jr Paul Department of Neurosurgery, University of Utah, Primary Children's Medical Center, 100 N. Medical Drive, 84113, Salt Lake City, UT, USA aut NATIONALLICENCE 700 1- Rao Ganesh Department of Neurosurgery, University of Utah, Primary Children's Medical Center, 100 N. Medical Drive, 84113, Salt Lake City, UT, USA aut NATIONALLICENCE 700 1- Brockmeyer Douglas Department of Neurosurgery, University of Utah, Primary Children's Medical Center, 100 N. Medical Drive, 84113, Salt Lake City, UT, USA aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/1(2007-01-01), 31-37 0256-7040 23:1<31 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer