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Endovascular treatment of pediatric intracranial arteriovenous shunt
Author(s) -
Niimi Yasunari
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13159
Subject(s) - medicine , shunt (medical) , arteriovenous fistula , arteriovenous malformation , hydrocephalus , macrocephaly , shunting , endovascular treatment , intracranial arteriovenous malformations , radiology , surgery , aneurysm , cerebral angiography , pediatrics , angiography
Intracranial arteriovenous shunts ( ICAVS ) in young children are characterized by frequent high‐flow fistulas. In association with high‐flow fistulas and the physiological condition of the developing brain and heart, each ICAVS type tends to present at a certain age with unique symptoms. Vein of Galen aneurysmal malformation ( VGAM ) and dural sinus malformation with arteriovenous ( AV ) shunt tend to present in the neonate with high output cardiac failure. In infancy, VGAM , pial arteriovenous fistula ( AVF ) and infantile dural AVF ( DAVF ) tend to present with hydrodynamic disorder such as macrocephaly, ventriculomegaly, prominent facial veins, and developmental delay. Pial AVF , AV malformation, and infantile DAVF can present with focal neurological signs such as seizure or hemorrhage at older ages. Endovascular treatment is currently the first choice of treatment for most pediatric ICAVS . The treatment goal should be defined on a patient‐by‐patient basis, according to the unique physiological condition of the child.