Functional and educational outcomes after treatment for intracranial arteriovenous malformations in children

Max J. van Essen, Kuo Sen Han, Rob T.H. Lo, Peter Woerdeman, Albert van der Zwan, Tristan P.C. van Doormaal*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Arteriovenous malformations (AVMs) in the pediatric population are rare, yet they form the most frequent cause of hemorrhagic stroke in children. Compared to adults, children have been suggested to have beneficial neurological outcomes. However, few studies have focused on other variables than neurological outcomes. This study aims to assess the long-term functional and educational outcomes of children after multimodality approach of treatment for intracranial AVMs. Methods: All children treated in our center between 1998 and 2016 for intracranial AVMs were reviewed. Patient characteristics, as well as AVM specifics, were collected. Functional outcomes were compared using the modified Rankin scale (mRs). Educational levels, using the International Standard Classification of Education (ISCED), were compared to the age-matched general population of the Netherlands. Results: In total, 25 children were included at mean age of 10 years (range 2–16 years). Nineteen patients (76%) presented with intracranial bleeding. Mean follow-up was 11.5 ± 5.3 years (range 4.1–24.4). Four (16%) of patients were treated with embolization, three (12%) with microsurgery, and 18 patients (72%) received a combination of different treatment modalities. Altogether, 21 (84%) were embolized, 14 (56%) were treated with microsurgery, and eight (32%) received stereotactic radiosurgery. One child had a worse mRs at discharge compared to admission; all others improved (n = 11) or were stable (n = 13). At follow-up, all patients scored a stable or improved mRs compared to discharge, with 23 children (92%) scoring mRs 0 or 1. These 23 children followed regular education during follow-up without specialized or adapted schooling. No significant differences in educational level with the age-matched general population were found. Conclusion: This retrospective review shows positive long-term results of both functional and educational outcomes after multidisciplinary treatment of pediatric brain AVMs.

Original languageEnglish
Pages (from-to)2199-2205
Number of pages7
JournalActa Neurochirurgica
Volume160
Issue number11
DOIs
Publication statusPublished - Nov 2018

Keywords

  • Arteriovenous malformation
  • Development
  • Education
  • Functional outcomes
  • Multimodality treatment
  • Pediatrics

Fingerprint

Dive into the research topics of 'Functional and educational outcomes after treatment for intracranial arteriovenous malformations in children'. Together they form a unique fingerprint.

Cite this