ArticleCerebrovascular diseases (Basel, Switzerland)2017
Morbidity after Hemorrhage in Children with Untreated Brain Arteriovenous Malformation.
Article in Cerebrovascular diseases (Basel, Switzerland), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Reporting of angiographic studies in patients diagnosed with a cerebral arteriovenous malformation: a systematic review.F1000Research · 2023Pooled it
- One-stop hybrid operation versus microsurgery for treating brain arteriovenous malformation in children-a retrospective case series.Translational pediatrics · 2024Article
- Multimodality Management in bAVM Surgery - Recent Experience from International Cerebrovascular Fellowship.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2021Article
- Long-term outcomes and prognostic predictors of 111 pediatric hemorrhagic cerebral arteriovenous malformations after microsurgical resection: a single-center experience.Neurosurgical review · 2021Article
- Natural history of high-grade pediatric arteriovenous malformations: implications for management options.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2020Article
- Contemporary management of brain arteriovenous malformations in mainland China: a web-based nationwide questionnaire survey.Chinese neurosurgical journal · 2020Article
- Pediatric brain arteriovenous malformation unfavorable hemorrhage risk: extrapolation to a morphologic model.Chinese neurosurgical journal · 2018Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundChildren with untreated brain arteriovenous malformations (bAVM) are at risk of encountering life-threatening hemorrhage very early in their lives. The primary aim of invasive treatment is to reduce unfavorable outcome associated with a bAVM rupture. A better understanding of the morbidity of bAVM hemorrhage might be helpful for weighing the risks of untreated bAVM and invasive treatment. Our aim was to assess the clinical outcome after bAVM rupture and identify features to predict severe hemorrhage in children.
methodsWe identified all consecutive children admitted to our institution for bAVMs between July 2009 and December 2014. Clinical outcome after hemorrhagic presentation and subsequent hemorrhage was evaluated using the modified Rankin Scale (mRS) for children. The association of demographic characteristics and bAVM morphology with severe hemorrhage (mRS >3 or requiring emergency hematoma evacuation) was studied using univariate and multivariable regression analyses. A nomogram based on multivariable analysis was formulated to predict severe hemorrhage risk for individual patients.
resultsA total of 134 patients were identified with a mean treatment-free follow-up period of 2.1 years. bAVM ruptured in 83 (62%) children: 82 had a hemorrhage at presentation and 6 of them experienced a recurrent hemorrhage during follow-up; 1 patient had other diagnostic symptoms but bled during follow-up. Among them, 49% (41/83) had a severe hemorrhage; emergency hematoma evacuation was required in 28% of them (23/83), and 24% (20/83) remained as disabled (mRS ≥3) at last follow-up. Forty-six percent (38/82) of children with hemorrhagic presentation were severely disabled (mRS >3). Forty-three percent (3/7) were severely disabled after subsequent hemorrhage. The annual rate of severe subsequent hemorrhage was 1% in the overall cohort and 3.3% in children with ruptured presentation. All the subsequent severe hemorrhage events occurred in children with severe hemorrhage history (7%, 3/41). Periventricular location, non-temporal lobe location, and long draining vein were predictors for severe hemorrhage in pediatric untreated bAVMs. A nomogram based on bAVM morphology was contracted to predict severe hemorrhage risk for individual patients, which was well calibrated and had a good discriminative ability (adjusted C-statistic, 0.72).
conclusionsEvaluating bAVM morbidity and morphology might be helpful for weighing the risks of untreated bAVM in pediatric patients.
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