Single-center experience with endovascular treatment of cerebral arteriovenous malformations with intent to cure in pediatric patients

Introduction: Arteriovenous malformations (AVMs) are the commonest cause of hemorrhagic stroke in children. Endovascular embolization is a feasible treatment modality, but cure rates are heterogenous from one series to another. We aimed to describe the immediate obliteration rates and periprocedural complications of embolization of pediatric AVMs. Methods: Between 2011 and 2019, participants below 18 years of age with AVMs treated by the same neurosurgeon at a single center were included. The clinical features, immediate angiographic results, and periprocedural complications were retrospectively collected from the clinical records. Results: Thirty-four embolization sessions were performed on 20 children (12 females with a mean age of 13). Intracranial hemorrhage was the most common presentation (75%), and the majority were frontal (30%) and basal ganglia (30%) lesions. An immediate complete angiographic obliteration was achieved in 9 patients (45%) with low-grade lesions (Spetzler-Martin grade I and II). NBCA was the most common embolic agent used (52.9%). Complications were reported in 3 (8.8%) out of 34 sessions. Two of them were intraoperative perforations with clinical consequences. A slight cortical hemorrhage during the procedure was observed in 1 patient without clinical repercussions. Discussion: This single-surgeon single-center experience suggests that endovascular treatment is a safe and efficient treatment for pediatric AVMs. Pediatric prognostic scores for a suitable selection of candidates are needed. Further studies are required to validate these results.

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Cerebral arteriovenous malformations in the era of embolization for angiographic cure: a single-center experience in Egypt

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-018-0003-5 ◽

2018 ◽

Vol 54 (1) ◽

Cited By ~ 1

Author(s):

Mohamed K Elewa

Keyword(s):

Arteriovenous Malformations ◽

Single Center ◽

Cerebral Arteriovenous Malformations ◽

Single Center Experience

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Letter to the Editor Regarding “Rupture Risk of Cerebral Arteriovenous Malformations During Pregnancy and Puerperium: A Single-Center Experience and Pooled Data Analysis”

World Neurosurgery ◽

10.1016/j.wneu.2018.02.165 ◽

2018 ◽

Vol 114 ◽

pp. 432-433 ◽

Cited By ~ 1

Author(s):

Ximeng Yang ◽

Gengfan Ye ◽

Daming Wang

Keyword(s):

Data Analysis ◽

Arteriovenous Malformations ◽

Rupture Risk ◽

Single Center ◽

Cerebral Arteriovenous Malformations ◽

Pooled Data ◽

Single Center Experience ◽

Letter To The Editor

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Endovascular treatment of cerebellar arteriovenous malformations: A single-center experience of 75 consecutive patients

Neurology India ◽

10.4103/0028-3886.284347 ◽

2020 ◽

Vol 68 (2) ◽

pp. 440

Author(s):

Ming Lv ◽

Yong Sun ◽

Qing Chang ◽

Wei You ◽

Peng Liu ◽

...

Keyword(s):

Endovascular Treatment ◽

Arteriovenous Malformations ◽

Single Center ◽

Single Center Experience

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Robotic versus open pyeloplasty in pediatric patients: a single center experience in Saudi Arabia

Minerva Urologica e Nefrologica ◽

10.23736/s0393-2249.18.03106-5 ◽

2018 ◽

Vol 70 (5) ◽

Cited By ~ 2

Author(s):

Noor N. Junejo ◽

Santiago Vallasciani ◽

Ahmad Alshammari ◽

Hossam Aljallad ◽

Saeed Alshahrani ◽

...

Keyword(s):

Saudi Arabia ◽

Pediatric Patients ◽

Single Center ◽

Single Center Experience ◽

Open Pyeloplasty

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Neuroblastoma with intracerebral metastases and the need for neurosurgery: a single-center experience

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.7.peds19143 ◽

2020 ◽

Vol 25 (1) ◽

pp. 51-56

Author(s):

Steffen Fleck ◽

Sascha Marx ◽

Clara Bobak ◽

Victoria Richter ◽

Stephan Nowak ◽

...

Keyword(s):

Pediatric Patients ◽

Neurosurgical Procedures ◽

Normal Brain ◽

Indications For Surgery ◽

Single Center ◽

Neurosurgical Procedure ◽

Oncological Treatment ◽

Single Center Experience ◽

Stage 4 ◽

Neurosurgical Treatment

OBJECTIVEIntracerebral metastases in neuroblastoma patients are rare, and information about the indication for and the outcome of neurosurgical procedures in this setting is scarce in the literature. The authors’ aim in the present study was to report a single-center experience with the neurosurgical treatment of intracerebral metastases in neuroblastoma.METHODSThis study is a retrospective single-center analysis of all neurosurgical strategies used in the treatment of intracerebral metastases in neuroblastoma patients.RESULTSBetween 2009 and 2017, 237 pediatric patients (94 girls, 143 boys) with a mean age of 39 months at diagnosis were treated for neuroblastoma. Five (2.1%) of the 237 patients had a neurosurgical procedure for intracerebral metastases. The metastases occurred a mean of 46 months after initial diagnosis. All of these patients had neuroblastoma stage 4. Indications for surgery were recurrent metastases after initial successful oncological treatment or progression of the metastasis under oncological treatment as well as deterioration of neurological function. Intraoperatively, the tumor usually had a distinguishable dissection plane but was infiltrative to adjacent nerves in some spots. Mean overall survival after the neurosurgical procedure was 22 months. Furthermore, in another 3 patients, a neurosurgical procedure was done for an intracranial but extracerebral metastasis.CONCLUSIONSNeurosurgical procedures for intracerebral metastases in neuroblastoma patients are rare and were performed in 2.1% of patients in the present study. Intracerebral metastases occurred during disease progression, and the prognosis after surgery was very limited. The main indications for surgery were rapid neurological deterioration or recurrence of the metastasis after initial successful oncological treatment. Intraoperatively, the metastases usually had a distinguishable dissection plane from the normal brain tissue.

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