caa a22 4500 463180593 CHVBK 20180406164838.0 cr unu---uuuuu 170326e20070801xx s 000 0 eng 10.1007/s00381-007-0322-9 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0322-9 Incidence of vascular malformations in spontaneous intra-cerebral haemorrhage in children [Elektronische Daten] [A. Papadias, A. Taha, S. Sgouros, A. Walsh, A. Hockley] Aim: To assess the incidence of vascular malformations in children presenting with non-traumatic intra-cerebral haemorrhage and outline the need for radiological investigations. Materials and methods: Between 1993 and 2002, 26 children presented with spontaneous intra-cerebral haemorrhage at a mean age of 26months (range 1-192months). Results: Twenty-two children had, as first treatment, surgical removal of the haematoma and any malformation found. One patient with no evidence of vascular malformation had conservative treatment, two had embolisation and one had stereotactic radiosurgery of arteriovenous malformations (AVMs). The diagnosis of vascular malformation was confirmed histologically and/or radiologically in 16 (61%) patients. Of these 16 patients, 7 were AVMs, 1 thrombosed middle cerebral artery (MCA) aneurysm, 1 cavernous angioma, 6 aggregates of abnormal vessels, 1 vein of Galen aneurysm. Pre-operatively, 12 patients had magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) and 7 were positive for vascular malformation (1 false positive) with no false negatives. Digital subtraction angiography (DSA) was performed pre-operatively in 7 patients, 4 were positive with no false negatives. There were no re-bleeds at the follow-up period. Five (19%) patients died from the haemorrhage, 7 (27%) had severe neurological deficit and 14 (54%) had no neurological deficit. Residual malformation after surgery requiring additional treatment was found in 3 (16%) patients. All patients with confirmed malformations were followed-up with DSA. Conclusion: MRI/MRA has high sensitivity and specificity in identifying vascular malformations in children presenting acutely with spontaneous intra-cerebral haemorrhage. This may prove useful when pre-operative DSA is not promptly available. After acute clot evacuation, there is high incidence of residual malformation and such patients should be followed-up with DSA. Springer-Verlag, 2007 Intra-cerebral haemorrhage nationallicence Arteriovenous malformation (AVM) nationallicence Arterial aneurysm nationallicence Cavernous malformation nationallicence Digital subtraction angiography (DSA) nationallicence Magnetic resonance imaging (MRI) nationallicence Magnetic resonance angiography (MRA) nationallicence Papadias A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut Taha A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut Sgouros S. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut Walsh A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut Hockley A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut Child's Nervous System Springer-Verlag 23/8(2007-08-01), 881-886 0256-7040 23:8<881 2007 23 381 https://doi.org/10.1007/s00381-007-0322-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0322-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Papadias A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut NATIONALLICENCE 700 1- Taha A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut NATIONALLICENCE 700 1- Sgouros S. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut NATIONALLICENCE 700 1- Walsh A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut NATIONALLICENCE 700 1- Hockley A. Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/8(2007-08-01), 881-886 0256-7040 23:8<881 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer