[Arteriovenous malformations in children: a report of four cases].
OBJECTIVE
Vascular malformations are the most frequent cause of intracranial haemorrhage (IH) after the neonatal period that are not due to traumatic injury. Arteriovenous malformations (AVM) are the vascular malformations that most often give rise to symptoms in infancy and are the most common cause of IH in children over one year of age.


METHODS
We reviewed the medical records of all patients under the age of 16 years diagnosed with AVM from the year 2000 to the present. Four cases aged between 7 and 15 years were found, all of whom were examined with computerised tomography and/or magnetic resonance imaging and cerebral arteriography scans. One patient started with headaches and another had learning disabilities. The other two began with IH, the most common clinical manifestations of which were a diminished level of awareness and vomiting. The final diagnosis was established by means of arteriography in all cases. Surgical treatment was carried out in three cases (using surgery, catheter embolisation and stereotaxic radiosurgery) and the patients' progress following the intervention was excellent.


CONCLUSIONS
Spontaneous haemorrhage constitutes the most common presenting symptom of AVM. However, there are sometimes earlier manifestations that are a challenge to diagnosis and which should be the target of future research, since preventing IH would lead to a drastic reduction in the morbidity and mortality rate of AVM.
Martin Fernandez-Mayoralas
D
D
Servico de Neuropediatría, Hospital Clinico San Carlos, 28040 Madrid, Espana. dmfmayor@yahoo.es
Munoz-Jareno
N
N
Santos-Martin
E
E
Mendez-Montero
J
J
Saiz-Ayala
A
A
Saldana
C J
CJ
Campos-Castello
J
J
D000293:Adolescent; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed