Comparative outcome of endovascular embolization with microsurgery in managing acute spontaneous cerebral hemorrhage in pediatric patients, an institutional experience
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
OBJECTIVES: A few previous studies have reported the role of embolization with curative intent in the treatment of the early phase of a spontaneous cerebral hemorrhage in pediatric patients, and its efficacy needs to be compared with surgery at the same time risk factors for hemorrhage following early embolization in such patients need to be evaluated.
METHODS: From a pool of 80 pediatric (< 18 years) who had undergone treatment for ruptured AVM with hemorrhage at our center between July 2018 and July 2022, we identified 36 patients with spontaneous bleeding due to AVM. Out of which, 20 were treated solely by embolization (group 1), while the remaining patients were treated surgically (with and without adjuvant embolization) (group 2).
RESULT: Spetzler-Martin's grading of the lesion suggested seven lesions < 3 and 13 lesions ≥ 3 in the embolization group. Similarly, seven lesions were < 3 and nine ≥ 3 Spetzler-Martin grade in the surgery group. Incomplete embolization was associated with hemorrhage in two patients treated with curative intent and four patients treated with embolization as adjuvant in the surgery group (p = 0.01). On follow-up, 18 patients in the embolization group and 12 in the surgery group had Glasgow outcome scores ≥ 4 (p = 0.273).
CONCLUSION: In the pediatric age group, incomplete embolization is the significant risk factor for hemorrhage in AVMs treated after a hemorrhagic stroke. Embolization with curative intent is as effective as surgery in treating such lesions as adjuvant embolization with careful patient selection.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
|---|---|
| Enthalten in: |
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery - 39(2023), 4 vom: 07. Apr., Seite 963-974 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Jha, Vikas Chandra [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Arteriovenous malformations |
|---|
| Anmerkungen: |
Date Completed 08.05.2023 Date Revised 12.05.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00381-022-05785-0 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM350830916 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM350830916 | ||
| 003 | DE-627 | ||
| 005 | 20231226045900.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00381-022-05785-0 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1169.xml |
| 035 | |a (DE-627)NLM350830916 | ||
| 035 | |a (NLM)36571597 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Jha, Vikas Chandra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparative outcome of endovascular embolization with microsurgery in managing acute spontaneous cerebral hemorrhage in pediatric patients, an institutional experience |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.05.2023 | ||
| 500 | |a Date Revised 12.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a OBJECTIVES: A few previous studies have reported the role of embolization with curative intent in the treatment of the early phase of a spontaneous cerebral hemorrhage in pediatric patients, and its efficacy needs to be compared with surgery at the same time risk factors for hemorrhage following early embolization in such patients need to be evaluated | ||
| 520 | |a METHODS: From a pool of 80 pediatric (< 18 years) who had undergone treatment for ruptured AVM with hemorrhage at our center between July 2018 and July 2022, we identified 36 patients with spontaneous bleeding due to AVM. Out of which, 20 were treated solely by embolization (group 1), while the remaining patients were treated surgically (with and without adjuvant embolization) (group 2) | ||
| 520 | |a RESULT: Spetzler-Martin's grading of the lesion suggested seven lesions < 3 and 13 lesions ≥ 3 in the embolization group. Similarly, seven lesions were < 3 and nine ≥ 3 Spetzler-Martin grade in the surgery group. Incomplete embolization was associated with hemorrhage in two patients treated with curative intent and four patients treated with embolization as adjuvant in the surgery group (p = 0.01). On follow-up, 18 patients in the embolization group and 12 in the surgery group had Glasgow outcome scores ≥ 4 (p = 0.273) | ||
| 520 | |a CONCLUSION: In the pediatric age group, incomplete embolization is the significant risk factor for hemorrhage in AVMs treated after a hemorrhagic stroke. Embolization with curative intent is as effective as surgery in treating such lesions as adjuvant embolization with careful patient selection | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Arteriovenous malformations | |
| 650 | 4 | |a Embolization | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Pediatric patients | |
| 650 | 4 | |a Spontaneous cerebral hemorrhage | |
| 650 | 4 | |a Surgery | |
| 700 | 1 | |a Alam, Mohammad Shahnawaz |e verfasserin |4 aut | |
| 700 | 1 | |a Sinha, Vivek Sharan |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery |d 1993 |g 39(2023), 4 vom: 07. Apr., Seite 963-974 |w (DE-627)NLM012695971 |x 1433-0350 |7 nnns |
| 773 | 1 | 8 | |g volume:39 |g year:2023 |g number:4 |g day:07 |g month:04 |g pages:963-974 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00381-022-05785-0 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 39 |j 2023 |e 4 |b 07 |c 04 |h 963-974 | ||