Pediatric Interventional Neuroradiology

Abstract

Pediatric neurovascular disorders can lead to substantial mortality and morbidity if not diagnosed early and adequately managed. Children with neurovascular diseases cannot be treated as small adults as the vascular and central nervous system anatomy, physiology, and pathologies in children differ greatly from those of adults. In addition, some neurovascular pathologies are seen exclusively in children such as aneurysmal malformation of the vein of Galen, pial fistulas, and dural fistulas in the context of dural sinus disease. In this review, we aim to present an overview of the common pediatric neurovascular diseases along with their endovascular management.

Keywords

pediatric - interventional neuroradiology - endovascular - aneurysms - fistula - stroke

Publication History

Article published online:
03 August 2023

• References

• 1 Sun LR, Harrar D, Drocton G, Castillo-Pinto C, Gailloud P, Pearl MS. Endovascular therapy for acute stroke in children: age and size technical limitations. J Neurointerv Surg 2021; 13 (09) 794-798
• 2 Requejo F, Teplisky DJ, Nguyen TN, Abdalkader M. Direct carotid artery access for neurointerventional procedures in infants. J Neurointerv Surg 2022; 14 (10) 973-975
• 3 He L, Ladner TR, Pruthi S. et al. Rule of 5: angiographic diameters of cervicocerebral arteries in children and compatibility with adult neurointerventional devices. J Neurointerv Surg 2016; 8 (10) 1067-1071
• 4 Requejo F, Teplisky D, González Dutra ML, Lipsch J, Nguyen TN, Abdalkader M. Intracranial arteriovenous shunts in infants: a decade of experience from a quaternary pediatric center. Interv Neuroradiol 2023; (e-pub ahead of print).
• 5 Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R. The management of vein of Galen aneurysmal malformations. Neurosurgery 2006; 59 (5, Suppl 3): S184-S194 , discussion S3–S13
• 6 Raybaud CA, Strother CM, Hald JK. Aneurysms of the vein of Galen: embryonic considerations and anatomical features relating to the pathogenesis of the malformation. Neuroradiology 1989; 31 (02) 109-128
• 7 Lv X, Jiang C, Wang J. Pediatric intracranial arteriovenous shunts: advances in diagnosis and treatment. Eur J Paediatr Neurol 2020; 25: 29-39
• 8 Ozanne A, Alvarez H, Krings T, Lasjaunias P. Pediatric neurovascular malformations: vein of Galen arteriovenous malformations (VGAM), pial arteriovenous malformations (pial AVM), dural sinus malformations (DSM) [in French]. J Neuroradiol 2007; 34 (03) 145-166
• 9 Regmi PR, Amatya I. Imaging of vein of Galen malformation in late trimester. J Patan Acad Health Sci. 2021; 8 (03) 117-121
• 10 Li TG, Zhang YY, Nie F, Peng MJ, Li YZ, Li PL. Diagnosis of foetal vein of galen aneurysmal malformation by ultrasound combined with magnetic resonance imaging: a case series. BMC Med Imaging 2020; 20 (01) 63
• 11 Orlov K, Gorbatykh A, Berestov V. et al. Superselective transvenous embolization with Onyx and n-BCA for vein of Galen aneurysmal malformations with restricted transarterial access: safety, efficacy, and technical aspects. Childs Nerv Syst 2017; 33 (11) 2003-2010
• 12 Abdalkader M, Hui F, Amans MR. et al. Cerebral venous disorders: diagnosis and endovascular management. J Neuroradiol 2023; (e-pub ahead of print).
• 13 Yang WH, Lu MS, Cheng YK, Wang TC. Pial arteriovenous fistula: a review of literature. Br J Neurosurg 2011; 25 (05) 580-585
• 14 Requejo F, Jaimovich R, Marelli J, Zuccaro G. Intracranial pial fistulas in pediatric population. Clinical features and treatment modalities. Childs Nerv Syst 2015; 31 (09) 1509-1514
• 15 Geibprasert S, Krings T, Armstrong D, Terbrugge KG, Raybaud CA. Predicting factors for the follow-up outcome and management decisions in vein of Galen aneurysmal malformations. Childs Nerv Syst 2010; 26 (01) 35-46
• 16 Tessler FN, Dion J, Viñuela F. et al. Cranial arteriovenous malformations in neonates: color Doppler imaging with angiographic correlation. AJR Am J Roentgenol 1989; 153 (05) 1027-1030
• 17 Requejo F, Tcherbbis V, Gonzalez ML, Argañaraz R, Marelli JM, Mantese B. Dural sinus malformation with giant pouch (DSMGP): symptoms and treatment. Childs Nerv Syst 2020; 36 (02) 343-348
• 18 Barbosa M, Mahadevan J, Weon YC. et al. Dural sinus malformations (DSM) with giant lakes, in neonates and infants. Review of 30 consecutive cases. Interv Neuroradiol 2003; 9 (04) 407-424
• 19 Lecce F, Robertson F, Rennie A. et al. Cross-sectional study of a United Kingdom cohort of neonatal vein of galen malformation. Ann Neurol 2018; 84 (04) 547-555
• 20 Requejo F, Mengide JP, González Dutra ML, Mantese B, Lipsich J. High-flow vascular malformations of the brain in pediatrics: experience in a tertiary care children's hospital. Arch Argent Pediatr 2021; 119 (03) 152-161
• 21 Nguyen TN, Chin LS, Souza R, Norbash AM. Transvenous embolization of a ruptured cerebral arteriovenous malformation with en-passage arterial supply: initial case report. J Neurointerv Surg 2010; 2 (02) 150-152
• 22 Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A. Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Childs Nerv Syst 2005; 21 (06) 437-450
• 23 de Aguiar GB, Ozanne A, Elawady A. et al. Intracranial aneurysm in pediatric population: a single-center experience. Pediatr Neurosurg 2022; 57 (04) 270-278
• 24 Greenham M, Gordon A, Anderson V, Mackay MT. Outcome in childhood stroke. Stroke 2016; 47 (04) 1159-1164
• 25 Sinclair AJ, Fox CK, Ichord RN. et al. Stroke in children with cardiac disease: report from the International Pediatric Stroke Study Group Symposium. Pediatr Neurol 2015; 52 (01) 5-15
• 26 Mackay MT, Wiznitzer M, Benedict SL, Lee KJ, Deveber GA, Ganesan V. International Pediatric Stroke Study Group. Arterial ischemic stroke risk factors: the International Pediatric Stroke Study. Ann Neurol 2011; 69 (01) 130-140
• 27 Bigi S, Dulcey A, Gralla J. et al. Feasibility, safety, and outcome of recanalization treatment in childhood stroke. Ann Neurol 2018; 83 (06) 1125-1132
• 28 Sporns PB, Kemmling A, Hanning U. et al. Thrombectomy in childhood stroke. J Am Heart Assoc 2019; 8 (05) e011335
• 29 Sporns PB, Sträter R, Minnerup J. et al. Feasibility, safety, and outcome of endovascular recanalization in childhood stroke: the Save ChildS study. JAMA Neurol 2020; 77 (01) 25-34
• 30 Mallick AA, Ganesan V, Kirkham FJ. et al. Childhood arterial ischaemic stroke incidence, presenting features, and risk factors: a prospective population-based study. Lancet Neurol 2014; 13 (01) 35-43
• 31 Bilgin C, Ibrahim M, Azzam AY. et al. Mechanical thrombectomy for pediatric large vessel occlusions : a systematic review and meta-analysis. Clin Neuroradiol 2023;
• 32 Ferriero DM, Fullerton HJ, Bernard TJ. et al; American Heart Association Stroke Council and Council on Cardiovascular and Stroke Nursing. Management of stroke in neonates and children: a scientific statement from the American Heart Association/American Stroke Association. Stroke 2019; 50 (03) e51-e96
• 33 Abdalkader M, Raftopoulos C, Finet P, Nguyen TN, Goffette P. Middle cerebral artery fenestration: thromboembolic and hemorrhagic complications. Interv Neuroradiol 2019; 25 (06) 644-647
• 34 Onoue K, Nguyen TN, Mian A, Dasenbrock H, Bedi H, Abdalkader M. Twig-like middle cerebral arteries: clinical and radiological findings. Clin Imaging 2021; 73: 31-37
• 35 Sun LR, Harrar D, Drocton G. et al. Mechanical thrombectomy for acute ischemic stroke: considerations in children. Stroke 2020; 51 (10) 3174-3181
• 36 Sporns PB, Straeter R, Minnerup J. et al; Save ChildS Investigators. Does device selection impact recanalization rate and neurological outcome?: an analysis of the Save ChildS study. Stroke 2020; 51 (04) 1182-1189
• 37 Vassiliadi DA, Mourelatos P, Kratimenos T, Tsagarakis S. Inferior petrosal sinus sampling in Cushing's syndrome: usefulness and pitfalls. Endocrine 2021; 73 (03) 530-539
• 38 Zampetti B, Grossrubatscher E, Dalino Ciaramella P, Boccardi E, Loli P. Bilateral inferior petrosal sinus sampling. Endocr Connect 2016; 5 (04) R12-R25
• 39 Schaiquevich P, Francis JH, Cancela MB, Carcaboso AM, Chantada GL, Abramson DH. Treatment of retinoblastoma: what is the latest and what is the future. Front Oncol 2022; 12: 822330
• 40 Requejo F, Marelli J, Ruiz Johnson A, Sampor C, Chantada G. The technique of superselective ophthalmic artery chemotherapy for retinoblastoma: The Garrahan Hospital experience. Interv Neuroradiol 2018; 24 (01) 93-99
• 41 Jia S, Wen X, Zhou M. et al. Comparison of intra-arterial chemotherapy efficacy delivered through the ophthalmic artery or external carotid artery in a cohort of retinoblastoma patients. Front Med (Lausanne) 2021; 8: 658305
• 42 Klufas MA, Gobin YP, Marr B, Brodie SE, Dunkel IJ, Abramson DH. Intra-arterial chemotherapy as a treatment for intraocular retinoblastoma: alternatives to direct ophthalmic artery catheterization. AJNR Am J Neuroradiol 2012; 33 (08) 1608-1614
• 43 Giorgianni A, Molinaro S, Agosti E. et al. Twenty years of experience in juvenile nasopharyngeal angiofibroma (JNA) preoperative endovascular embolization: an effective procedure with a low complications rate. J Clin Med 2021; 10 (17) 3926
• 44 Gemmete JJ, Patel S, Pandey AS. et al. Preliminary experience with the percutaneous embolization of juvenile angiofibromas using only ethylene-vinyl alcohol copolymer (Onyx) for preoperative devascularization prior to surgical resection. AJNR Am J Neuroradiol 2012; 33 (09) 1669-1675