Abstract：
OBJECTIVE: Cerebral arteriovenous malformations (AVMs) are a challenging pathology in pediatric patients, carrying a high risk of morbidity and mortality. Treatment modalities include resection, endovascular embolization, and stereotactic radiosurgery. There is currently no consensus favoring one modality over another. Timing of multimodal therapy with embolization/stereotactic radiosurgery and resection is not well explored in the literature. We present a series of pediatric patients with AVMs, with special attention directed to the timing of treatment.
METHODS: Electronic medical records of all pediatric patients (<18 years old at treatment) with AVMs treated at our institution were retrospectively reviewed after institutional review board approval. Demographic information, AVM characteristics, treatment variables, and outcomes were recorded.
RESULTS: In our cohort of 27 patients, 21 (77.8%) presented with a ruptured AVM. Of these patients, 6 (28.6%) had a Glasgow Coma Scale score of 3-10 and underwent treatment within 24 hours of presentation, and 10 (47.6%) with a Glasgow Coma Scale score of 12-15 were treated between 24 and 120 hours after presentation. The remaining 5 patients (23.8%) were treated 3 weeks to 14 months after AVM rupture. Regardless of rupture status, 96% of our cohort had a modified Rankin Scale score of 1-2 at most recent follow-up.
CONCLUSIONS: We present our institution\'s experience with pediatric AVMs, focusing on the timing of treatment. Based on our experience, early treatment of AVMs seems to be safe and effective regardless of rupture status.
METHODS: Electronic medical records of all pediatric patients (<18 years old at treatment) with AVMs treated at our institution were retrospectively reviewed after institutional review board approval. Demographic information, AVM characteristics, treatment variables, and outcomes were recorded.
RESULTS: In our cohort of 27 patients, 21 (77.8%) presented with a ruptured AVM. Of these patients, 6 (28.6%) had a Glasgow Coma Scale score of 3-10 and underwent treatment within 24 hours of presentation, and 10 (47.6%) with a Glasgow Coma Scale score of 12-15 were treated between 24 and 120 hours after presentation. The remaining 5 patients (23.8%) were treated 3 weeks to 14 months after AVM rupture. Regardless of rupture status, 96% of our cohort had a modified Rankin Scale score of 1-2 at most recent follow-up.
CONCLUSIONS: We present our institution\'s experience with pediatric AVMs, focusing on the timing of treatment. Based on our experience, early treatment of AVMs seems to be safe and effective regardless of rupture status.
摘要：
目的：脑动静脉畸形（AVM）是儿科患者具有挑战性的病理，携带高发病率和死亡率的风险。治疗方式包括切除，血管内栓塞和立体定向放射外科（SRS）。目前没有共识赞成一种方式而不是另一种方式。在文献中没有很好地探索栓塞/SRS和切除的多模式治疗的时机。这里我们介绍了一系列儿科AVM患者，特别注意治疗的时机。
方法：在IRB批准后，对在我们机构接受AVM治疗的所有儿科患者（治疗时<18年）的电子病历进行回顾性审查。人口统计信息,AVM特性，记录治疗变量和结局.
结果：共纳入27例患者。21例（77.8%）出现AVM破裂。6例患者（28.6%）的GCS为3～10，并在24小时内接受治疗。10名GCS为12至15的患者（47.6％）在24至120小时内接受治疗。5例患者(23.8%)在AVM破裂后3周至14个月接受治疗。我们队列的96%，不管破裂状态如何，在最近的随访中mRS为1-2。
结论：我们介绍了我们机构在小儿AVM方面的经验，专注于治疗的时机。根据我们的经验,无论破裂状态如何,AVM的早期治疗似乎都是安全有效的.
方法：在IRB批准后，对在我们机构接受AVM治疗的所有儿科患者（治疗时<18年）的电子病历进行回顾性审查。人口统计信息,AVM特性，记录治疗变量和结局.
结果：共纳入27例患者。21例（77.8%）出现AVM破裂。6例患者（28.6%）的GCS为3～10，并在24小时内接受治疗。10名GCS为12至15的患者（47.6％）在24至120小时内接受治疗。5例患者(23.8%)在AVM破裂后3周至14个月接受治疗。我们队列的96%，不管破裂状态如何，在最近的随访中mRS为1-2。
结论：我们介绍了我们机构在小儿AVM方面的经验，专注于治疗的时机。根据我们的经验,无论破裂状态如何,AVM的早期治疗似乎都是安全有效的.
