- To provide a comprehensive evidence based revision of Brain Vascular Malformations (BVM) in pediatric patients. - To review the BVMclassification,
keeping in mind the concepts of “target” (where),
“timing” (when) and “triggering” (why). - To describe the most common radiological findings in pediatric´s BVM.
Pediatric BVM are uncommon and have different features compared to adults,
and this is relevant for their classification and treatment. Traditionally BVM are classified in shunting (Arterio Venous Shunt-AVS) or non-shunting lesions Fig. 1 ,
and AVS were divided according to arterial supply,
pial or dural.
This classification is inaccurate in children,
because: Cerebral eloquence is difficult to evaluate. Most lesions are fistulas or multifocal. The drainage pattern usually involves the entire...
Findings and procedure details
We retrospectively review pediatrics BVM in our department since 2010.
Imaging explorations were acquired according to institutional protocol and documentedby CT,
US or DSA. Developmental Venous Anomaly (DVA) was the most common BVM.
Arterio-Venous Malformations (AVM) was the most frequent entity among the groupwith AVS. BVM WITH AV SHUNT 1.- FOCAL LESIONS (late triggering event) 1.1.- Pial AV shunt Pial arteriovenous shunts are abnormal connections between arteries that would normally...
BVMs are seldomin pediatric patients,
but entail an important cause of morbidity and mortality. Early diagnosis and treatment of pediatric BVMs are important due to the risk of hemorrhage and potential neurologic deficits.
Therefore the particular features of neonatal and infant brains assume a group of nonhemorrhagic manifestations (essentially rapid cerebral atrophy and cardiac failure) and therapeutic adversities different from adults.
Pediatric Vascular Malformations of the Brain: Concepts and Classifications,
Diagnosis and Endovascular Treatment.
Heidelberg:Springer; 2015. Krings T.,
Segmental neurovascular syndromes in children.
Neuroimaging Clin N Am.
2007;17:245–58. Lasjaunias PL.,
New York: Springer; 2007. Lasjaunias PL.,