儿童脑动静脉畸形自然史

Natural history of pediatric cerebral arteriovenous malformation

脑动静脉畸形(cAVM)是一种先天性脑血管畸形,是最常见的儿童自发性颅内出血原因。儿童cAVM的自然史与成人存在差异,其患病率随年龄增长而增加,总体诊断率较低。儿童cAVM破裂出血比例高,预后不佳,且终生累积出血风险高于成人期诊断患者。此外,儿童cAVM生长现象更为常见。该文综述儿童cAVM与成人cAVM在自然史上的差异,为儿童cAVM采取与成人cAVM不同的治疗策略提供参考。

Cerebral arteriovenous malformation(cAVM) is a congenital cerebrovascular disease. It is the most common cause of pediatric spontaneous intracerebral hemorrhage. Natural history of pediatric cAVM and adult cAVM is different. The incidence of cAVM increases with age. The discrepancy between incidence and detective rate of normal population indicates the underdiagnosed situation of cAVM. Children are prone to hemorrhage and the prognosis of hemorrhage is poor. Accumulated hemorrhage risk of pediatric cAVM is higher than that of adult patients. Furthermore, cAVM growth is more common in pediatric population. The purpose of this paper is to review the differences in the natural history of childhood cAVM and adult cAVM, and to provide reference for the different treatment strategies of childhood cAVM and traditional adult cAVM.