Semin Neurol 2020; 40(03): 303-314
DOI: 10.1055/s-0040-1708869
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

High-Flow Vascular Malformations in Children

Ramin A. Morshed
1  Department of Neurological Surgery, University of California San Francisco, San Francisco, California
,
Ethan A. Winkler
1  Department of Neurological Surgery, University of California San Francisco, San Francisco, California
,
Helen Kim
3  Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California
,
Steve Braunstein
4  Department of Radiation Oncology, University of California San Francisco, San Francisco, California
,
Daniel L. Cooke
3  Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California
,
Steven W. Hetts
3  Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California
,
Adib A. Abla
1  Department of Neurological Surgery, University of California San Francisco, San Francisco, California
,
Heather J. Fullerton
2  Department of Neurology, University of California San Francisco, San Francisco, California
5  Department of Pediatrics, University of California San Francisco, San Francisco, California
,
Nalin Gupta
1  Department of Neurological Surgery, University of California San Francisco, San Francisco, California
5  Department of Pediatrics, University of California San Francisco, San Francisco, California
› Author Affiliations
Further Information

Publication History

Publication Date:
06 April 2020 (online)

Abstract

Children can have a variety of intracranial vascular anomalies ranging from small and incidental with no clinical consequences to complex lesions that can cause substantial neurologic deficits, heart failure, or profoundly affect development. In contrast to high-flow lesions with direct arterial-to-venous shunts, low-flow lesions such as cavernous malformations are associated with a lower likelihood of substantial hemorrhage, and a more benign course. Management of vascular anomalies in children has to incorporate an understanding of how treatment strategies may affect the normal development of the central nervous system. In this review, we discuss the etiologies, epidemiology, natural history, and genetic risk factors of three high-flow vascular malformations seen in children: brain arteriovenous malformations, intracranial dural arteriovenous fistulas, and vein of Galen malformations.