A retrospective evaluation of demographic, morphological and clinical characteristics of pediatric patients with cerebrovascular malformation

Objective: In this study, it was aimed to evaluate the demographic, morphological and clinical characteristics of pediatric patients with cerebrovascular malformatıon at the Pediatric Intensive Care Unit and Neurosurgery in Ege University Faculty of Medicine (EÜTF) between the years 2009-April 2015 retrospectively. Materials and Methods: The study was held retrospectively among the pediatric patients with cerebrovascular malformation monitored at the EÜTF pediatric intensive care unit and Neurosurgery between the years 2009-April 2015. After scanning the files of patients, the demographic, morphologic and clinical data of patients were recorded. Type of cerebrovascular malformation, type of presentation, lesion location, lesion size, venous and arterial drainage, Spetzler-Martin grading scale, treatment choices, complications were recorded. Treatment success, treatment complication, the current status of patients were recorded by a telephone interview. Results: The patients who were included in this study were 53 % girls and 47 % boys. The mean age at diagnosis was 10.3 for AVM, 8.8 for cavernoma. The average hospitalization in intensive care was 4.9 days. The mean duration of invasive mechanical ventilation was 1.5 days. Type of presentations were 58 % headache, 16 % seizure, 16 % focal neurological defisit, 8 % hemorrhage for AVM; 66 % seizure, 33 % headache for cavernom. AVM locations were 83 % hemispheric, 4 % thalamic, 4 % cerebellar, 4 % pineal, 4 % pons. Cavernoma locations were hemispheric for all. Hemorrhage was accompanied 17 (70 %) patients with AVM. The hemorrhage rate for AVM was higher and it was found statistical significant (p<0.05). Surgery was performed 14 patients (%58), endovascular embolization was performed 3 patients(%12) , radiosurgery was performed 1 patient (%4) and combined treatment was performed 4 patients (%16). Surgery was performed for all cavernomas. The complication rate was higher for cavernomas and it was found statistical significant (p<0.05). Conclusion: Congenital cerebrovascular malformations are important group of intracranial lesions in the pediatric age group. The hemorrhage rate for AVM was higher than cavernoma. The complication rate for cavernoma was higher than AVM. Cerebrovascular malformations's early diagnosis and treatment are important. Key words: Cerebrovascular malformation, arteriovenous malformation, cavernoma, hemorrhage, pediatrics