Hsiao Mei-Cheng, Tsuei Yuang-Seng, Pan Hung-Chuan, Sun Ming-Hsi, Chen Wen-Hsien, Chen Hung-Chieh, Shen Chiung-Chyi, Li Chi-Ruei, Chou Yu-Cheng
Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung 407, Taiwan.
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan.
Medicina (Kaunas). 2025 Jun 29;61(7):1177. doi: 10.3390/medicina61071177.
: Pediatric cerebral arteriovenous malformations (AVMs) are associated with significant morbidity and mortality. The aim of this study was to assess the long-term outcomes of surgical excision and stereotactic radiosurgery (SRS) of cerebral AVMs in pediatric patients. : A single-center retrospective analysis was conducted using data obtained from a single medical center between January 2012 and July 2022. The Modified Rankin Scale (mRS) at admission and discharge and the Spetzler-Martin (SM) scores were analyzed. : Among 45 patients (mean age 11.8 years), 19 patients (42.2%) received surgical resection, with good outcomes (mRS 0-2) in 16 patients and complete obliteration in all patients. In total, 26 patients (57.8%) were managed with SRS. After 36.3 months on average, complete obliteration in 19 of 26 patients (69.2%) was confirmed. Among the 7 SRS patients without complete obliteration, 6 had residual cerebral AVMs at the last follow-up, and 1 had recurrence. All patients receiving SRS had favorable outcomes (mRS 0-1) and no apparent radiosurgery-related complications. : In our study, the surgical resection or SRS was selected based on individual patient conditions, and the overall outcomes were satisfactory. Both surgical resection and SRS proved to be effective treatment options. Microsurgical resection demonstrated a high rate of obliteration and remains a favorable therapeutic choice with acceptable risks for pediatric AVMs.
小儿脑动静脉畸形（AVM）与显著的发病率和死亡率相关。本研究的目的是评估小儿患者脑AVM手术切除和立体定向放射外科治疗（SRS）的长期疗效。：采用单中心回顾性分析，数据来源于2012年1月至2022年7月间的一个医疗中心。分析了入院和出院时的改良Rankin量表（mRS）以及Spetzler-Martin（SM）评分。：45例患者（平均年龄11.8岁）中，19例（42.2%）接受了手术切除，16例患者预后良好（mRS 0-2），所有患者均实现完全闭塞。共有26例患者（57.8%）接受了SRS治疗。平均36.3个月后，26例患者中有19例（69.2%）被证实完全闭塞。在7例未完全闭塞的SRS患者中，6例在最后一次随访时有残留脑AVM，1例复发。所有接受SRS治疗的患者预后良好（mRS 0-1），且无明显的放射外科相关并发症。：在我们的研究中，根据患者个体情况选择手术切除或SRS，总体疗效令人满意。手术切除和SRS均被证明是有效的治疗选择。显微手术切除显示出较高的闭塞率，对于小儿AVM来说，仍然是一种具有可接受风险的良好治疗选择。
