title: Role of follow-up imaging after resection of brain arteriovenous malformations in pediatric patients: a systematic review of the literature.
abstract: OBJECTIVE Pediatric patients are at risk for the recurrence of brain arteriovenous malformation (AVM) after resection. While there is general consensus on the importance of follow-up after surgical removal of an AVM, there is a lack of consistency in the duration of that follow-up. The object of this systematic review was to examine the role of follow-up imaging in detecting AVM recurrence early and preventing AVM rupture. METHODS This systematic review was performed using articles obtained through a search of the literature contained in the MeSH database, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Search results revealed 1052 articles, 13 of which described 31 cases of AVM recurrence meeting the criteria for inclusion in this study. Detection of AVM occurred significantly earlier (mean ± SD, 3.56 ± 3.67 years) in patients with follow-up imaging than in those without (mean 8.86 ± 5.61 years; p = 0.0169). While 13.34% of patients who underwent follow-up imaging presented with rupture of a recurrent AVM, 57.14% of those without follow-up imaging presented with a ruptured recurrence (p = 0.0377). CONCLUSIONS Follow-up imaging has an integral role after AVM resection and is sometimes not performed for a sufficient period, leading to delayed detection of recurrence and an increased likelihood of a ruptured recurrent AVM.
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Joaquin E
authors.initials: JE
authors.lastname: Jimenez
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Zachary C
authors.initials: ZC
authors.lastname: Gersey
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Jason
authors.initials: J
authors.lastname: Wagner
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Brian
authors.initials: B
authors.lastname: Snelling
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Peterson
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods
keywords: AVM = arteriovenous malformation; DSA = digital subtraction angiography; SM = Spetzler-Martin; arteriovenous malformation; follow-up imaging; pediatrics; recurrence; vascular disorders