[Arteriovenous malformations of the brain in children: treatment results for 376 patients].

undefined: Cerebral arteriovenous malformations (AVM) are increasingly detected in children. Цель исследования: Оценка результатов различных методов лечения АВМ головного мозга у детей и определение риска кровоизлияния до и после лечения. Материал и методы: В исследование включено 376 пациентов с АВМ головного мозга различной локализации в возрасте до 17 лет включительно. Пациентов с интракраниальным кровоизлиянием было 273 (72,6%). Results: Recurrent hemorrhages within the first month were registered in 1.1% of patients with angiomatous AVM prior to treatment and in 15.4% of patients with fistulous AVM. Microsurgical resection of AVM was performed in 135 (35.9%) patients. Total resection was achieved in 97.8% of cases. There were no mortality after microsurgical procedures. Endovascular treatment was applied in 79 (21%) patients. Total embolization was achieved in 29.1% of patients. One patient (1.3%) died after endovascular procedure. Radiosurgery was performed in 140 (37.2%) patients with total obliteration after a single fraction in 64.4% of patients. Favorable long-term outcomes (GOS grades V-IV) were achieved in 89.6% of patients with available follow-up data (n=182). Recurrent hemorrhages were registered in 6% of patients (3.3% after radiosurgery, 2.7% after endovascular treatment). One patient with recurrent hemorrhage died after radiosurgery. Conclusion: Early relapses of hemorrhage are not characteristic for children with cerebral AVM. Therefore, there are no indications for urgent surgery except for cases of intracerebral hematoma. In children, microsurgical treatment is preferred for angiomatous AVM, endovascular treatment - for fistulous AVM. Radiosurgery also ensures favorable outcomes. However, it is unreasonable to postpone AVM radiosurgical treatment in children with increased risk of recurrent hemorrhage considering relatively long period of post-radiation obliteration of AVM.