Clinical Characteristics Of 130 Children With Brain Arteriovenous Malformations

Objective:As the main cause of spontaneous intracranial hemorrhage(SIH)in children,brain arteriovenous malformation(BAVM)is in sharp focus by plenty of pediatric neurosurgeons.This study aims to analyse the clinical characteristics and treatment of BAVM in children.Methods:A total of 130 cases of brain arteriovenous malformations in our hospital from March 2011 to March 2021 met criteria was collected.And the demographics,clinical manifestations,imaging characteristics,treatment strategies and prognosis were analyzed.Results:The incidence rate of brain arteriovenous malformation was the highest in school-age children(66%),with an average age of(8.4±3.2)years.The length of hospitalization was concentrated within 30 days,with an average length of(16.5±10.7)days.The onset time is more within 3 days;88%of the patient cohort initially presented hemorrhage symptoms as headache or vomiting,28%of the patient showed consciousness disturbance and 19%of the patients showed convulsion,respectively.Some of the patients showed neurological dysfunction such as hemiplegia,facial paralysis,aphasia and urinary incontinence.Imaging data indicated that AVM nidus were mainly supplied by the front cycle(70%),in which the middle cerebral artery was the most important supplying artery.Deep venous drainage was presented in part of the cohort(28%).Other intracranial lesions accompanying BAVM were ventricle hemorrhage,subarachnoid hemorrhage and hydrocephalus,etc.Surgical resection(29%)was the first choice of treatment strategies,and other operations including simple hematoma removal(22%),Ommaya drainage(16%),and ventricular drainage(17%)were performed in some cases.The prognosis data was under the evaluation of the clinical recovery in patients,and the mRS showed that 81%of patients had a better recurrence.Conclusion:Brain arteriovenous malformations in children has the characteristics of rapid onset,obvious clinical symptoms.The main manifestation is intracranial hemorrhage,which requires earlier detection,diagnosis and treatment.DSA is more recommended than CTA in diagnostic methods for higher effectiveness.The prognosis of most children is good after proper treatments.