Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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This study aims to analyze the clinical and radiological findings, timing and type of treatment, and outcome in children under 1 year of age that presented with neurosurgical vascular malformations. ⋯ In this neonatal age group (first year of life), we can find the whole range of neurosurgical vascular pathology: VGAM, AVM, cavernous malformation, DSM, pial AVF, DAVF, and sacular aneurysm. VGAM is the most frequent vascular malformation during the first year of age. The early treatment of vascular malformations prevents its adverse effects on a developing brain. A multidisciplinary team composed by endovascular and surgical specialists is necessary to discuss and treat each case.
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Pediatric aneuryms are rare and have characteristics that distinguish them from their adult counterparts. There is a greater capacity for pediatric aneurysms to arise de novo and progress rapidly. ⋯ The need for continued follow-up cannot be overstated for this patient group, therefore, nor can the collaborative efforts of both surgeons and interventionalists to design the most appropriate treatment approach.
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Hemorrhage from an arteriovenous malformation (AVM) is the commonest cause of childhood stroke. Management options for children include observation and medical management, surgical resection, endovascular embolization, or stereotactic radiosurgery, alone or in combination. ⋯ Radiosurgery is the first and only biologic AVM therapy; it represents the beginnings of future cellular approaches to vascular malformation diseases. For this reason, the future of radiosurgery may be impacted positively by the development of other biologic strategies such as brain protection or endothelial sensitization.