Language
English
Publication Date
9-1-2026
Journal
Medicina
DOI
10.3390/medicina62091679
PMID
42796286
PMCID
PMC13609203
PubMedCentral® Posted Date
9-1-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Background and Objectives: brain arteriovenous malformations (AVMs) are a leading cause of spontaneous intracranial hemorrhage in children and carry a disproportionately high lifetime hemorrhagic risk.
Materials and Methods: We retrospectively analyzed clinical, morphological, and surgical factors associated with functional outcome in 30 consecutive pediatric patients (≤18 years) who underwent microsurgical AVM resection at a single tertiary neurosurgical center between January 2015 and December 2025.
Results: Functional status was assessed with the modified Rankin Scale (mRS) at hospital discharge and at 6–9 months of follow-up; the Wilcoxon signed-rank test, Mann–Whitney U test, Fisher’s exact test, Spearman correlation, and univariable logistic regression were used for analysis. Complete resection on early postoperative CT angiography was documented in all 30 patients (100%). The proportion with a favorable outcome (mRS 0–2) improved significantly from 50.0% at discharge to 76.7% at follow-up (p < 0.0001); 80.8% of survivors improved by at least one mRS point, and none deteriorated. In univariable analysis, the variable most strongly associated with poor outcome was intraventricular hemorrhage (IVH; odds ratio [OR] 28.5, 95% CI 2.65–306.6; p = 0.002); the wide confidence interval reflects the small number of events and precludes a precise estimate of effect size. Lower admission Glasgow Coma Scale (GCS) score (p = 0.0006), higher Supplemented Spetzler–Martin (S–M) grade (p = 0.019), and postoperative complications (p = 0.016) were likewise associated with poor outcome. Because these associations are univariable and unadjusted for confounding, they should be regarded as exploratory and hypothesis-generating rather than as independent predictors. All four deaths occurred in malformations in eloquent locations (p = 0.037). Microsurgical resection achieved complete resection on early postoperative CT angiography in all patients; however, functional recovery appeared to be associated primarily with the severity of the initial hemorrhagic insult—particularly IVH—and with lesion complexity rather than with the achievement of angiographic resection alone.
Conclusions: Given the small, surgically selected cohort and the limited follow-up, these findings require confirmation in larger multicenter studies.
Keywords
Humans, Female, Intracranial Arteriovenous Malformations, Retrospective Studies, Child, Male, Treatment Outcome, Adolescent, Child, Preschool, Infant, Microsurgery, Logistic Models, Neurosurgical Procedures, arteriovenous malformation, pediatric neurosurgery, microsurgical resection, intraventricular hemorrhage, modified Rankin Scale, Spetzler–Martin grade, functional outcome, cerebrovascular disease
Published Open-Access
yes
Recommended Citation
Tasić, Goran; Janićijević, Aleksandar; Kostić, Jelena; et al., "Beyond Resection: Determinants of Outcome After Pediatric Brain Arteriovenous Malformation Surgery" (2026). Faculty, Staff and Students Publications. 8612.
https://digitalcommons.library.tmc.edu/baylor_docs/8612