Evaluation of intracranial arteriovenous malformations (AVM) and arteriovenous fistulas (AVF) other than vein of galen in pediatric age group

EVALUATION OF INTRACRANIAL ARTERIOVENOUS MALFORMATIONS (AVM) AND ARTERIOVENOUS FISTULAS (AVF) OTHER THAN VEIN OF GALEN IN PEDIATRIC AGE GROUP Objective: To reveal the results of our clinic by evaluating the clinical, radiologic, treatment modalities and outcomes of patients under 20 years of age admitted to Cerrahpaşa Medical Faculty Neurointerventional Radiology Department with AVM and AVF. Materials and Methods: Pre- and post-procedure images (CT, CTA, MR, MRA, DSA) of AVM and AVF patients in the population under 20 years of age between 01.01.2005-01.01.2024 in the Department of Radiology, Division of Neuroradiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine were retrospectively evaluated. Results: DSAs of 1080 patients were evaluated and 93 (8.6%) AVM and 30 (2.7%) AVF patients aged 20 years and younger were identified. Among AVM patients, 46 were male and 47 were female. The mean age at diagnosis was 14 years in AVM patients. Seventeen (17) male and 13 (13) female AVF patients were observed. Twelve (40%) of the AVF patients were Pial- AVF, 11 (36.7%) Dural- AVF, 7 (23.3%) KKF. The mean age at diagnosis was 9.9 years in AVF patients. 29 AVM and 26 AVF patients underwent embolization treatment in our clinic. Post-procedural bleeding was detected in 3 AVM patients, ischemia in 4 patients and residual filling was detected in 9 patients at the 1st year follow-up. In 4 AVF patients, residual filling was observed at the 1st year follow-up. Conclusion: Intracranial hypertension, motor deficits and epilepsy were clinically more frequent in AVMs with high hemodynamic burden, and Spetzler Martin Score and Embocure Score were higher in these patients. Steal phenomenon is more common in posterior fossa and cortical localized AVMs. Posterior fossa localized AVMs fed by the SSA are more difficult to treat as high grade vascular pathologies. Residual/recurrent filling is observed more frequently in AVMs fed by ECA branches in post-treatment control imaging. In dural AVF patients, recurrence/residual filling is observed more frequently after embolization treatment. Keywords: AVM, AVF, CCF, Embolization Therapy, SSA