Explore the rare and intriguing phenomenon of spontaneous thrombosis in pediatric arteriovenous fistulae through our latest case series and in-depth literature review.
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Spontaneous thrombosis of high flow pediatric arteriovenous fistulae: Case series of two patients and a comprehensive literature review.
Chen et al., Childs Nerv Syst 2023
DOI: 10.1007/s00381-023-06241-3
Summary of Pediatric Pial Arteriovenous Shunts Natural History and Intervention
Pediatric pial arteriovenous shunts, which are rare and complex vascular anomalies in the brain and spine, are not well understood due to their low incidence and diverse presentations. This study contributes to the literature by presenting two cases that highlight the potential for spontaneous thrombosis of these shunts. The first case involves an infant with a history of intracranial hemorrhage from a ruptured pial fistula, who was found to have a second fistula that spontaneously thrombosed before elective embolization. The second case describes a 5-year-old with a vertebro-vertebral fistula that also spontaneously thrombosed before planned intervention.
Importance: These cases are significant because they suggest that some high-flow pial arteriovenous fistulae may have the capacity to spontaneously resolve, which could influence the management of these conditions in children.
Contribution to Literature: The authors provide a review of the literature on pediatric single-hole fistulae of the brain and spine, offering morphologic insights that may help identify which fistulae are more likely to undergo spontaneous thrombosis. This knowledge could reduce unnecessary intervention risks in young patients.