Endovascular treatment of pediatric intracranial arteriovenous shunt

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.