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Original Paper

Pediatric Cryptic Vascular Malformations: Presentation, Diagnosis and Treatment

Ciricillo S.F. · Cogen P.H. · Edwards M.S.B.

Author affiliations

Division of Pediatric Neurosurgery, Departments of Neurological Surgery and Pediatrics, University of California, San Francisco, Calif., USA

Related Articles for ""

Pediatr Neurosurg 1994;20:137–147

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 13, 1993
Accepted: May 27, 1993
Published online: March 06, 2008
Issue release date: 1994

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE

Abstract

Since the advent of magnetic resonance (MR) imaging, angiographically occult or ‘cryptic’ vascular malformations (CVMs) have been detected with increasing frequency in the pediatric population. The natural history of these lesions is uncertain and treatment remains controversial. We retrospectively reviewed the presentation, radiology, treatment and outcome of 37 pediatric patients with CVMs seen at our institution between 1982 and 1992. MR imaging was diagnostic in all patients studied. Angiography was negative in 20 of 21 patients studied, while 1 teenage girl was found to have a venous malformation. Total surgical excision was the treatment goal in all patients presenting with symptomatic CVMs. There has been no surgical mortality. Perioperative complications occurred in one third of the patients but quickly resolved in most cases. Only 2 patients with multiple CVMs, including brainstem lesions, who presented with progressive neurologic deficits were clearly worse following surgery. Six of seven patients with radiation-induced CVMs have remained asymptomatic with close radiographic follow-up, while 1 patient with a hemorrhage has required surgical evacuation. We conclude that CVMs occur more commonly in the pediatric population than previously assumed. Patients presenting with seizures or hemorrhage should undergo craniotomy with the goal of complete excision. Radiation therapy plays no role in the treatment of these lesions and may actually result in their formation. Careful clinical and radiological follow-up is critical to assess the completeness of surgical removal and to evaluate progression of lesions in patients with multiple or radiation-induced CVMs treated conservatively.

© 1994 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 13, 1993
Accepted: May 27, 1993
Published online: March 06, 2008
Issue release date: 1994

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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