Details

Autor(en) / Beteiligte

• Tam, Ka Yue
• Lim, Kevin
• Zhu, Cannon Xian Lun
• Chan, Kit Ying
• Poon, Wai Sang
• Poon, Darren
• Kam, Michael
• Cheung, Michael
• Wong, Kwok Chu George

Titel

Long-term outcomes of ruptured cerebral arteriovenous malformations in the paediatric population: A retrospective review in a regional hospital in Hong Kong

Ist Teil von

• Journal of clinical neuroscience, 2019-08, Vol.66, p.66-70

Ort / Verlag

Scotland: Elsevier Ltd

Erscheinungsjahr

2019

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Good outcome can be achieved in paediatric ruptured bAVM patients.•A protocol of microsurgery and radiosurgery can achieve good long term outcome.•Most patients recovered well with minor deficit. The objective of the study is to evaluate the management outcomes of ruptured cerebral arteriovenous malformations (bAVMs) in the paediatric population in a regional hospital in Hong Kong. We performed a retrospective review between 1 January 1999 and 31 December 2017 for ruptured bAVM in a regional neurosurgical centre in Hong Kong. All other vascular pathologies and unruptured cases were excluded. Thirty-three eligible patients were included for analysis. The median age at presentation was 12 (3–18), with a slight male preponderance. Presenting complaints included headache (60.6%), motor deficits (24.2%), and seizure (6.1%). Glasgow coma scale (GCS) on presentation (median, IQR) was 15 (13–15). bAVMs were lobar in 57.6%, infratentorial in 27.3%, and basal ganglia in 9.1%. Follow-up was 101 ± 61 months and ranged from 24 to 229 months. 12 (36.4%) patients underwent emergency haematoma evacuation with or without bAVM excision because of neurological deterioration in the acute phase. 7 (21.2%) patients underwent interval excision and 11(33.3%) patients underwent stereotactic radiosurgery (SRS). There was no residual bAVM and no Clavien-Dindo complications greater than grade II in interval surgery group. Those who underwent SRS had a significantly higher Spetzler-Martin grade; bAVM obliteration was achieved at 73.3%, without any major symptomatic post-radiosurgery complications. There was 1 (3%) mortality and 30 (90.9%) patients recovered well with minor non-disabling deficits (GOS 5). For paediatric patients with ruptured bAVM, a satisfactory management outcome can be achieved with careful patient selection for surgery and radiosurgery.