Abstract：
Pediatric pial arteriovenous shunts in the brain and spine are challenging to understand because of low incidence, variable presentation, and associations with genetic syndromes. What is known about their natural history comes from reviews of small series. To better understand the natural history and role for intervention, two cases are presented followed by a review of the literature. In the first case, an infant with a prior history of intracranial hemorrhage from a ruptured pial fistula returns for elective embolization for a second pial fistula which was found to be spontaneously thrombosed 2 weeks later. In the second case, a 5-year-old with a vertebro-vertebral fistula, identified on work up for a heart murmur and documented with diagnostic angiography, is brought for elective embolization 6 weeks later where spontaneous thrombosis is identified. In reviewing the literature on pediatric single-hole fistulae of the brain and spine, the authors offer some morphologic considerations for identifying which high-flow fistulae may undergo spontaneous thrombosis to decrease the potentially unnecessary risk associated with interventions in small children.
摘要：
由于发病率低，小儿脑和脊柱的脑动静脉分流具有挑战性，变量表示，以及与遗传综合征的关联。关于他们的自然历史的知识来自小系列的评论。为了更好地了解自然历史和干预作用，介绍了两个案例，然后回顾了文献。在第一种情况下,1例既往有颅内瘘破裂出血史的婴儿返回择期栓塞治疗2周后发现自发形成血栓的第二个静脉瘘.在第二种情况下，一个患有脊椎-脊椎瘘的5岁孩子,确定了心脏杂音的工作，并记录了诊断血管造影，6周后进行选择性栓塞，确定自发性血栓形成。在回顾有关小儿单孔脑和脊柱瘘的文献时，作者提供了一些形态学考虑因素,以确定哪些高流量瘘可能发生自发性血栓形成,从而降低与幼儿干预相关的潜在不必要风险.
