Neurology and Neurosurgery

Oct. 03, 2020

Intervention is critical in maximizing the outcomes of pediatric arteriovenous malformations (AVMs). Although short-term functional outcomes following interventions have been established as favorable, long-term outcomes haven't been thoroughly studied.

In a systematic review and meta-analysis published in Clinical Neurology and Neurosurgery in 2020, Mayo Clinic researchers found that favorable functional outlooks for pediatric patients with AVMs can persist for many years after initial intervention. The researchers identified 14 pertinent studies describing outcomes for 699 pediatric patients with AVMs, with a median 75% of patients presenting with hemorrhage. The use of surgery, embolization and radiosurgery were reported by 12 (86%), 14 (100%) and 10 (71%) studies, respectively.

By a median study follow-up time of 4.1 years, a favorable functional outcome was estimated to occur in 87% of patients across all 14 studies. Hemorrhagic versus nonhemorrhagic presentations didn't statistically differ in the incidence of this long-term outcome.

Although formal protocols don't yet exist for pediatric AVM intervention, the metadata suggest that intervention of any type can lead to favorable long-term functional outcomes for most patients. The researchers further suggest that the risk of long-term functional deficit shouldn't be the sole factor in deciding whether to pursue intervention.

For more information

Lu VM, et al. Long-term functional outcome after intervention for pediatric intracranial arteriovenous malformations: A systematic review and meta-analysis. Clinical Neurology and Neurosurgery. 2020;191:105707.