Systematic literature review of central nervous system vascular malformations treatment in children

Ieva Montvilaitė1, Saulius Ročka2, 3

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania

2Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Neurology and Neurosurgery, Vilnius, Lithuania

3Vilnius University Hospital Santaros klinikos, Center of Neurosurgery, Vilnius Lithuania


Background. Vascular malformations can be characterized by a high risk of bleeding, so their appropriate and early treatment is important to preserve and extend the patient’s life and avoid long-term complications related to the pathology that severely impair the quality of life.

Purpose. Evaluate, which treatment is the best for vascular malformations in children worldwide.

Material and methods. During the literature review, a search for scientific articles was performed in the PubMed database and included reviews, which were written in English between 2000 – 2020 and were controlled studies.

Results. Radiosurgery is the most chosen and studied treatment for arteriovenous malformation in children. The overall incidence of complications in patients with arteriovenous malformations treated with radiosurgery was 23 %. Complete obliteration was achieved in 70 % of patients. The first-line treatment for arteriovenous fistula was embolization. Complete obliteration after endovascular treatment was achieved in 78.4 % of cases. 96 % of patients with Galenic venous malformations were treated endovascularly. The incidence of complications was 73.9 %, complete obliteration was achieved 42.9 %. 92 % of patients had a surgery for cavernous malformations. The incidence of complications was 3.8 %.

Conclusions. Microsurgery, radiosurgery, embolization are used to treat vascular malformations in the pediatric population, but treatment is individual in each case. All three treatments are used for the treatment of arteriovenous malformation, it is selected individually. The predominant treatment for arteriovenous fistulas and vein of Galen
malformations is endovascular and for cavernous malformations is microsurgery.

Keywords: arteriovenous malformation; cavernomas; arteriovenous fistula; vein of Galen malformation; treatment; child; childhood.

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