Tangled Throughout Life: A Case of Paediatric Ruptured Cerebral Arteriovenous Malformation

Article Sidebar

PDF
Published: Oct 31, 2021
Keywords:
Arteriovenous malformations, Intracranial haemorrhages, Cerebral haemorrhage, Paediatrics, Child

Main Article Content

Syed Muhammad Hafiz Syed Hassan
Emergency Department, Hospital Selayang, 68100 Batu Caves, Selangor, Malaysia
Nurul Huda Ahmad
Department of Emergency Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia

Abstract

Arteriovenous malformation (AVM) in children is uncommon occurrence defined as presence of arteriovenous shunt- ing through coiled and tortuous vascular connections. We discussed a case of a 3-year old girl presented with acute left facial asymmetry and right-sided limb weakness. Neurological examination revealed MRC scale of 0 out of 5 for power on her right side. Magnetic Resonance Angiography (MRA) revealed bilateral thalamic AVM. Surgical resection was not advisable in view of deep-seated location. Paediatric AVM most often become apparent following rupture with majority presents with headache. Ruptured paediatric AVM carries high burden of morbidity and mortality. Paediatric intracranial haemorrhage posed tremendous concern regarding its long-term outcome. Treatment would be more appropriate sooner rather than later especially for those presented with ruptured AVM. Surgical resection remains the gold standard treatment for all accessible paediatric AVMs with embolization and radiosurgery as adjunctive therapies. AVM in paediatric population is rare but carries grim prognosis.

Downloads

Download data is not yet available.

Article Details

How to Cite
Syed Hassan, S. M. H., & Ahmad, N. H. (2021). Tangled Throughout Life: A Case of Paediatric Ruptured Cerebral Arteriovenous Malformation. Malaysian Journal of Medicine and Health Sciences, 17(4), 413–415. Retrieved from http://mjmhsojs.upm.edu.my/index.php/mjmhs/article/view/509
Issue
Vol. 17 No. 4 (2021)
Section
Case Report

References

Millar C, Bissonette B, Humphreys RP. Cerebral arteriovenous malformations in children. Can J Anaesth. 1994;41(4):321-331.

El-Ghanem M, Kass-Hout T, Kass-Hout O, Alderazi YJ, Amuluru K, Al-Mufti F, et al. Arteriovenous Malformations in the Pediatric Population: Review of the Existing Literature. Intervent Neurol. 2016;5:218–225.

Ma L, Chen X, Chen Y, Wu C, Ma J, Zhao Y. Subsequent haemorrhage in children with untreated brain arteriovenous malformation: Higher risk with unbalanced inflow and outflow angioarchitecture. Eur Radiol. 2017;27:2868–2876.

Blauwblomme T, Bourgeois M, Meyer P, Puget S, Di Rocco F, Boddaert N, et al. Long-term outcome of 106 consecutive pediatric ruptured brain arteriovenous malformations after combined treatment. Stroke. 2014;45:1664-1671.

Cunli Y, Khoo LS, Lim PJ, Lim EH. CT Angiography versus Digital Subtraction angiography for intracranial vascular pathology in a clinical setting. Med J Malaysia. 2013;68(5):415-423.