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Natural history and clinical manifestation of Pediatric Brain Arteriovenous Malformations

  • Received : 2024.02.14
  • Accepted : 2024.04.16
  • Published : 2024.05.01

Abstract

Brain arteriovenous malformations (bAVMs) are aberrant arteriovenous shunts through a vascular nidus with no intervening capillary beds. They are one of the commonest causes of spontaneous intracranial haemorrhage in children and may be associated with significant morbidity and mortality in cases of rupture. Treatment strategies include microsurgical resection, endovascular embolisation, stereotactic radiosurgery, multimodality treatment with a combination thereof, and particularly in high-grade bAVMs, conservative management. Clinicians involved in treating bAVMs need to have familiarity with the natural history pertaining to bAVMs in terms of risk of rupture, risk factors elevating rupture risk as well as understanding the clinical manifestations of bAVMs. This invited review serves to provide a synthesis on natural history and clinical presentation of bAVMs with particular focus in children to inform decision-making pertaining to management.

Keywords

References

  1. Abecassis IJ, Xu DS, Batjer HH, Bendok BR : Natural history of brain arteriovenous malformations: a systematic review. Neurosurg Focus 37 : E7, 2014 
  2. Anderson RC, McDowell MM, Kellner CP, Appelboom G, Bruce SS, Kotchetkov IS, et al. : Arteriovenous malformation-associated aneurysms in the pediatric population. J Neurosurg Pediatr 9 : 11-16, 2012 
  3. Aoun SG, Bendok BR, Batjer HH : Acute management of ruptured arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am 23 : 87-103, 2012 
  4. Beecher JS, Lyon K, Ban VS, Vance A, McDougall CM, Whitworth LA, et al. : Delayed treatment of ruptured brain AVMs: is it ok to wait? J Neurosurg 128 : 999-1005, 2018 
  5. Berman MF, Sciacca RR, Pile-Spellman J, Stapf C, Connolly ES Jr, Mohr JP, et al. : The epidemiology of brain arteriovenous malformations. Neurosurgery 47 : 389-396; discussion 397, 2000 
  6. Bervini D, Morgan MK, Ritson EA, Heller G : Surgery for unruptured arteriovenous malformations of the brain is better than conservative management for selected cases: a prospective cohort study. J Neurosurg 121 : 878-890, 2014 
  7. Bristol RE, Albuquerque FC, Spetzler RF, Rekate HL, McDougall CG, Zabramski JM : Surgical management of arteriovenous malformations in children. J Neurosurg 105(2 Suppl) : 88-93, 2006 
  8. Chen CJ, Ding D, Derdeyn CP, Lanzino G, Friedlander RM, Southerland AM, et al. : Brain arteriovenous malformations: a review of natural history, pathobiology, and interventions. Neurology 95 : 917-927, 2020 
  9. Choi JH, Mast H, Sciacca RR, Hartmann A, Khaw AV, Mohr JP, et al. : Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation. Stroke 37 : 1243-1247, 2006 
  10. Choi JH, Mohr JP : Brain arteriovenous malformations in adults. Lancet Neurol 4 : 299-308, 2005 
  11. Cockroft KM : Natural history of brain arteriovenous malformations in Harbaugh RE, Shaffrey C, Couldwell WT, Berger MS (eds) : Neurosurgery Knowledge Update: A Comprehensive Review, 1st ed. New York : Thieme, 2015, pp155-160 
  12. da Costa L, Wallace MC, Ter Brugge KG, O'Kelly C, Willinsky RA, Tymianski M : The natural history and predictive features of hemorrhage from brain arteriovenous malformations. Stroke 40 : 100-105, 2009 
  13. Darsaut TE, Guzman R, Marcellus ML, Edwards MS, Tian L, Do HM, et al. : Management of pediatric intracranial arteriovenous malformations: experience with multimodality therapy. Neurosurgery 69 : 540-556; discussion 556, 2011 
  14. Derdeyn CP, Zipfel GJ, Albuquerque FC, Cooke DL, Feldmann E, Sheehan JP, et al. : Management of brain arteriovenous malformations: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 48 : e200-e224, 2017 
  15. Dicpinigaitis AJ, Ogulnick JV, Mayer SA, Gandhi CD, Al-Mufti F : Increase in ruptured cerebral arteriovenous malformations and mortality in the united states: unintended consequences of the ARUBA trial? Stroke Vasc Interv Neurol 3 : e000442, 2023 
  16. Dodier P, Kranawetter B, Hirschmann D, Dogan M, Cho A, Untersteiner H, et al. : Outcome of 107 conservatively managed unruptured brain arteriovenous malformations: a single center's 30-year experience. J Neurosurg 139 : 1025-1035, 2023 
  17. Ellis JA, Mejia Munne JC, Lavine SD, Meyers PM, Connolly ES Jr, Solomon RA : Arteriovenous malformations and headache. J Clin Neurosci 23 : 38-43, 2016 
  18. Ellis MJ, Armstrong D, Vachhrajani S, Kulkarni AV, Dirks PB, Drake JM, et al. : Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations. J Neurointerv Surg 5 : 191-195, 2013 
  19. Friedlander RM : Clinical practice. Arteriovenous malformations of the brain. N Engl J Med 356 : 2704-2712, 2007 
  20. Fung LW, Ganesan V : Arteriovenous malformations presenting with papilloedema. Dev Med Child Neurol 46 : 626-627, 2004 
  21. Goldberg J, Raabe A, Bervini D : Natural history of brain arteriovenous malformations: systematic review. J Neurosurg Sci 62 : 437-443, 2018 
  22. Gross BA, Du R : Natural history of cerebral arteriovenous malformations: a meta-analysis. J Neurosurg 118 : 437-443, 2013 
  23. Gross BA, Du R : Rate of re-bleeding of arteriovenous malformations in the first year after rupture. J Clin Neurosci 19 : 1087-1088, 2012 
  24. Gross BA, Storey A, Orbach DB, Scott RM, Smith ER : Microsurgical treatment of arteriovenous malformations in pediatric patients: the Boston Children's Hospital experience. J Neurosurg Pediatr 15 : 71-77, 2015 
  25. Haas DC : Arteriovenous malformations and migraine: case reports and an analysis of the relationship. Headache 31 : 509-513, 1991 
  26. Halim AX, Johnston SC, Singh V, McCulloch CE, Bennett JP, Achrol AS, et al. : Longitudinal risk of intracranial hemorrhage in patients with arteriovenous malformation of the brain within a defined population. Stroke 35 : 1697-1702, 2004 
  27. Haridas A, Dashti R, Shokunhfar T, Shaibani A : Pediatric Arteriovenous Malformations in Di Rocco C, Pang D, Rutka JT (eds) : Textbook of Pediatric Neurosurgery. Cham : Springer, 2020, Vol 2, pp1135-1168 
  28. Hirschmann D, Goebl P, Witte FH, Gatterbauer B, Wang WT, Dodier P, et al. : Evaluation of the radiosurgical treatment of cerebral arteriovenous malformations: a retrospective single-center analysis of three decades. J Neurointerv Surg 12 : 401-406, 2020 
  29. Hoffman C, Riina HA, Stieg P, Allen B, Gobin YP, Santillan A, et al. : Associated aneurysms in pediatric arteriovenous malformations and the implications for treatment. Neurosurgery 69 : 315-322, 2011 
  30. Karlsson B, Jokura H, Yang HC, Yamamoto M, Martinez R, Kawagishi J, et al. : The NASSAU (new assessment of cerebral arteriovenous malformations yet unruptured) analysis: are the results from the ARUBA trial also applicable to unruptured arteriovenous malformations deemed suitable for Gamma Knife surgery? Neurosurgery 85 : E118-E124, 2019 
  31. Kellner CP, McDowell MM, Phan MQ, Connolly ES, Lavine SD, Meyers PM, et al. : Number and location of draining veins in pediatric arteriovenous malformations: association with hemorrhage. J Neurosurg Pediatr 14 : 538-545, 2014 
  32. Kondziolka D, McLaughlin MR, Kestle JR : Simple risk predictions for arteriovenous malformation hemorrhage. Neurosurgery 37 : 851-855, 1995 
  33. Kupersmith MJ, Vargas ME, Yashar A, Madrid M, Nelson K, Seton A, et al. : Occipital arteriovenous malformations: visual disturbances and presentation. Neurology 46 : 953-957, 1996 
  34. Magro E, Gentric JC, Darsaut TE, Ziegler D, Bojanowski MW, Raymond J : Responses to ARUBA: a systematic review and critical analysis for the design of future arteriovenous malformation trials. J Neurosurg 126 : 486-494, 2017 
  35. Mahalick DM, Ruff RM, Hoi SU : Neuropsychological sequelae of arteriovenous malformations. Neurosurgery 29 : 351-357, 1991 
  36. Mast H, Mohr JP, Osipov A, Pile-Spellman J, Marshall RS, Lazar RM, et al. : 'Steal' is an unestablished mechanism for the clinical presentation of cerebral arteriovenous malformations. Stroke 26 : 1215-1220, 1995 
  37. Mohr JP, Overbey JR, Hartmann A, Kummer RV, Al-Shahi Salman R, Kim H, et al. : Medical management with interventional therapy versus medical management alone for unruptured brain arteriovenous malformations (ARUBA): final follow-up of a multicentre, non-blinded, randomised controlled trial. Lancet Neurol 19 : 573-581, 2020 
  38. Mohr JP, Parides MK, Stapf C, Moquete E, Moy CS, Overbey JR, et al. : Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet 383 : 614-621, 2014 
  39. Nagata S, Morioka T, Natori Y, Sasaki T : Surgical treatment of nonruptured giant occipital arteriovenous malformations with frequent migraine-like headache. Neurol Med Chir (Tokyo) 46 : 441-445, 2006 
  40. Niazi TN, Klimo P Jr, Anderson RC, Raffel C : Diagnosis and management of arteriovenous malformations in children. Neurosurg Clin N Am 21 : 443-456, 2010 
  41. Plumptre I, Robertson F, Rennie A, James G, Syed SB : Atypical capillary malformations with subsequent diplegia: a difficult case of capillary malformation-arteriovenous malformation syndrome. Pediatr Dermatol 37 : 162-164, 2020 
  42. Pollock BE, Link MJ, Stafford SL, Garces YI, Foote RL : Stereotactic radiosurgery for arteriovenous malformations: the effect of treatment period on patient outcomes. Neurosurgery 78 : 499-509, 2016 
  43. 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 89 : 540-551, 2016 
  44. Sahlein DH, Mora P, Becske T, Huang P, Jafar JJ, Connolly ES, et al. : Features predictive of brain arteriovenous malformation hemorrhage: extrapolation to a physiologic model. Stroke 45 : 1964-1970, 2014 
  45. Sheth RD, Bodensteiner JB : Progressive neurologic impairment from an arteriovenous malformation vascular steal. Pediatr Neurol 13 : 352-354, 1995 
  46. Solomon RA, Connolly ES Jr : Arteriovenous malformations of the brain. N Engl J Med 376 : 1859-1866, 2017 
  47. Soltanolkotabi M, Schoeneman SE, Alden TD, Hurley MC, Ansari SA, DiPatri AJ Jr, et al. : Onyx embolization of intracranial arteriovenous malformations in pediatric patients. J Neurosurg Pediatr 11 : 431-437, 2013 
  48. Spetzler RF, Ponce FA : A 3-tier classification of cerebral arteriovenous malformations. Clinical article. J Neurosurg 114 : 842-849, 2011 
  49. Stapf C, Mast H, Sciacca RR, Berenstein A, Nelson PK, Gobin YP, et al. : The New York Islands AVM Study: design, study progress, and initial results. Stroke 34 : e29-e33, 2003 
  50. Stapf C, Mast H, Sciacca RR, Choi JH, Khaw AV, Connolly ES, et al. : Predictors of hemorrhage in patients with untreated brain arteriovenous malformation. Neurology 66 : 1350-1355, 2006 
  51. Stapf C, Mohr JP, Pile-Spellman J, Solomon RA, Sacco RL, Connolly ES Jr : Epidemiology and natural history of arteriovenous malformations. Neurosurg Focus 11 : e1, 2001 
  52. Valdivielso-Ramos M, Martin-Santiago A, Azana JM, Hernandez-Nunez A, Vera A, Perez B, et al. : Capillary malformation-arteriovenous malformation syndrome: a multicentre study. Clin Exp Dermatol 46 : 300-305, 2021 
  53. van Beijnum J, Lovelock CE, Cordonnier C, Rothwell PM, Klijn CJ, Al-Shahi Salman R, et al. : Outcome after spontaneous and arteriovenous malformation-related intracerebral haemorrhage: population-based studies. Brain 132 : 537-543, 2009 
  54. Yamada S, Takagi Y, Nozaki K, Kikuta K, Hashimoto N : Risk factors for subsequent hemorrhage in patients with cerebral arteriovenous malformations. J Neurosurg 107 : 965-972, 2007 
  55. Yang W, Liu A, Hung AL, Braileanu M, Wang JY, Caplan JM, et al. : Lower risk of intracranial arteriovenous malformation hemorrhage in patients with hereditary hemorrhagic telangiectasia. Neurosurgery 78 : 684-693, 2016 
  56. Zhang Y, Chen Y, Han H, Ma L, Li R, Li Z, et al. : Timing of microsurgical resection for ruptured brain arteriovenous malformations: a propensity score-matched analysis using prospective single-center registry data. J Neurosurg 140 : 164-171, 2023