Vasküler Hastalıklar, Venöz Anjiomlar ve Vasküler Anomalilerde Cerrahi Yaklaşım
Özet
Çocukluk çağı travma dışı beyin kanamalarının en yaygın sebebi olan vasküler patolojiler; anevrizma, AVM, kavernom, dAVF, Moyamoya hastalığı, kapiller telenjiektazi ve venöz anjiom gibi çeşitli anomalileri kapsar. Tanı süreci genellikle DSA gibi görüntüleme yöntemleriyle kesinleştirilirken, tedavi stratejileri vakanın özelliklerine bağlı olarak mikrocerrahi, radyocerrahi veya endovasküler girişimlerin multidisipliner kullanımıyla belirlenir. Erken teşhis ve doğru planlama, hastaların nörolojik sekelsiz bir yaşam sürme şansını artırmak için kritik öneme sahiptir.
Pediatric non-traumatic brain hemorrhages are primarily caused by diverse vascular pathologies, including aneurysms, AVMs, cavernomas, dAVFs, Moyamoya disease, capillary telangiectasias, and venous angiomas. Diagnosis is typically established through advanced imaging like DSA, while treatment strategies involve a multidisciplinary approach, utilizing microsurgery, radiosurgery, or endovascular interventions tailored to the specific case. Early detection and precise therapeutic planning are essential to maximize the patient's likelihood of achieving a life free from neurological sequelae.
Referanslar
Deora H, Rao KVLN, Somanna S, Srinivas D, Shukla DP, Bhat DI. Surgically Managed Pediatric Intracranial Aneurysms: How Different Are They from Adult Intracranial Aneurysms? Pediatr Neurosurg. 2017;52(5):313-317.
Hetts SW, Narvid J, Sanai N, Lawton MT, Gupta N, Fullerton HJ, Dowd CF, Higashida RT, Halbach VV. Intracranial aneurysms in childhood: 27-year single-institution experience. AJNR Am J Neuroradiol. 2009 Aug;30(7):1315-24.
Ostergaard JR. Aetiology of intracranial saccular aneurysms in childhood. Br J Neurosurg. 1991;5(6):575-80.
Kanaan I, Lasjaunias P, Coates R. The spectrum of intracranial aneurysms in pediatrics. Minim Invasive Neurosurg. 1995 Mar;38(1):1-9.
Kuo CH, McGrath LB, Carnevale JA, Marupudi NI, Ojemann JG, Ellenbogen RG, Wang AC. Atypical Presentation of Giant Aneurysm in Pediatric Patient with Duane Syndrome. World Neurosurg. 2018 Aug;116:25-28.
Gonçalves VM, Cristino N, Cunha E Sá M. Spontaneous thrombosis in giant aneurysm of the anterior communicating artery complex in pediatric age: five-year follow-up. Case Rep Vasc Med. 2014;2014:236041.
Shinkawa T, Ramakrishnaiah RH, Eble BK. Subarachnoid haemorrhage from undiagnosed mycotic aortic aneurysm in a child. Cardiol Young. 2018 Mar;28(3):461-463.
Skoch J, Tahir R, Abruzzo T, Taylor JM, Zuccarello M, Vadivelu S. Predicting symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network in a pediatric population. Childs Nerv Syst. 2017 Dec;33(12):2153-2157.
Gaballah M, et al. Intraoperative cerebral angiography in arteriovenous malformation resection in children: a single institutional experience. J Neurosurg Pediatr. 2014;13:222–228.
Blamek S, Larysz D, Miszczyk L. Stereotactic linac radiosurgery and hypofractionated stereotactic radiotherapy for pediatric arteriovenous malformations of the brain: experiences of a single institution. Childs Nerv Syst. 2013;29:651–656.
Karhunen PJ, Penttila A, Erkinjuntti T. Arteriovenous malformation of the brain: imaging by postmortem angiography. Forensic Sci Int. 1990;48:9–19.
Da Costa L, Wallace M C, Brugge K G T, O’Kelly C, Willinsky RA, Tymianski M. The natural history and predictive features of hemorrhage from brain arteriovenous malformations. Stroke 2009 vol.40,no.1,pp.100–105.
Osipov A, Koennecke H-C, Hartmann A et al. Seizures in cerebral arteriovenous malformations:type,clinical course,and medical management, Interventional Neuroradiology 1997 vol.3,no. 1,pp.37–41.
Hernesniemi JA, et al. Natural history of brain arteriovenous malformations: a long-term follow-up study of risk of hemorrhage in 238 patients. Neurosurgery. 2008;63:823 829. discussion 829–831.
. Stapf C, et al. Predictors of hemorrhage in patients with untreated brain arteriovenous malformation. Neurology. 2006;66:1350–1355
Griffiths PD, Beveridge CJ, Gholkar A. Angiography in non-traumatic brain haematoma. An analysis of 100 cases. Acta Radiol. 1997;38:797–802.
. Yamamoto M, et al. Long-term follow-up results of intentional 2-stage gamma knife surgery with an interval of at least 3 years for arteriovenous malformations larger than 10 cm3 . J Neurosurg. 2012;117(suppl):126–134.
Willinsky RA, et al. Delayed angiography in the investigation of intracerebral hematomas caused by small arteriovenous malformations. Neuroradiology. 1993;35:307–311.
Sanchez-Mejia RO, et al. Superior outcomes in children compared with adults after microsurgical resection of brain arteriovenous malformations. J Neurosurg. 2006;105(2 suppl):82–87.
Darsaut TE, et al. Management of pediatric intracranial arteriovenous malformations: experience with multimodality therapy. Neurosurgery. 2011;69:540–556. discussion 556.
Blount JP, et al. History of surgery for cerebrovascular disease in children. Part III. Arteriovenous malformations. Neurosurg Focus. 2006;20:E11.
Schaller C, Schramm J. Microsurgical results for small arteriovenous malformations accessible for radiosurgical or embolization treatment. Neurosurgery. 1997;40:664–672. discussion 672–674.
Heros RC, Korosue K, Diebold PM. Surgical excision of cerebral arteriovenous malformations: late results. Neurosurgery. 1990;26:570–577. discussion 577–578.
Hamilton MG, Spetzler RF. The prospective application of a grading system for arteriovenous malformations. Neurosurgery. 1994;34:2–6. discussion 6–7.
Frizzel RT, Fisher WS., 3rd Cure, morbidity, and mortality associated with embolization of brain arteriovenous malformations: a review of 1,246 patients in 32 series over a 35-year period. Neurosurgery. 1995;37:1031–1039. discussion 1039–1040.
Kondziolka D, et al. Radiosurgical management of pediatric arteriovenous malformations. Childs Nerv Syst. 2010;26:1359–1366.
Bristol RE, et al. Surgical management of arteriovenous malformations in children. J Neurosurg. 2006;105(2 suppl):88–93.
Gross BA, Lin N, Du R, Day AL. The natural history of intracranial cavernous malformations. Neurosurgical focus. 2011;30:E24
Al-Holou WN, O’Lynnger TM, Pandey AS, Gemmete JJ, Thompson BG, Muraszko KM, et al. Natural history and imaging prevalence of cavernous malformations in children and young adults. J Neurosurg Pediatr. 2012;9:198–205.
Pizon V, Chardin P, Lerosey I, Olofsson B, Tavitian A. Human cDNAs rap1 and rap2 homologous to the Drosophila gene Dras3 encode proteins closely related to ras in the ‘effector’ region. Oncogene. 1988;3:201–4
Ruggieri R, Bender A, Matsui Y, Powers S, Takai Y, Pringle JR, et al. RSR1, a ras-like gene homologous to Krev-1 (smg21A/rap1A): Role in the development of cell polarity and interactions with the Ras pathway in Saccharomyces cerevisiae. Mol Cell Biol. 1992;12:758–66.
Patel P, Patel NV, Danimarka SF. Kafa içi MR kılavuzluğunda lazerle indüklenen termal terapi: Visualase termal terapi sistemiyle tek merkezli deneyim. J Nöroşirürji. 2016:1–8.
Wang Z, Qian C, Shi L, Wang L, Zhang J, Wang Y. Surgery Approaches to Brainstem Cavernous Malformations. J Craniofac Surg. 2015;26:e577–80.
Sheehan J. Transcranial ultrasound for arteriovenous malformations: Something old is new again. World Neurosurg. 2012;77:269–70.
Zhang N, Pan L, Wang BJ, Wang EM, Dai JZ, Cai PW. Gamma knife radiosurgery for cavernous hemangiomas. J Neurosurg. 2000;93(Suppl 3):S74–7.
Gandhi D, Chen J, Pearl M, Huang J, Gemmete JJ, Kathuria S.Intracranial dural arteriovenous fistulas: classification, imaging findings, and treatment.AJNR Am J Neuroradiol. 2012; 33:1007–1013.
Kim MS, Han DH, Kwon OK, Oh CW, Han MH.Clinical characteristics of dural arteriovenous fistula.J Clin Neurosci. 2002; 9:147–155. doi: 10.1054/jocn.2001.1029.
Sarma D, ter Brugge K.Management of intracranial dural arteriovenous shunts in adults. Eur J Radiol. 2003; 46:206–220.
Satomi J, van Dijk JM, Terbrugge KG, Willinsky RA, Wallace MC.Benign cranial dural arteriovenous fistulas: outcome of conservative management based on the natural history of the lesion.J Neurosurg. 2002; 97:767–770.
Lucas Cde P, Zabramski JM.Dural arteriovenous fistula of the transverse-sigmoid sinus causing trigeminal neuralgia.Acta Neurochir (Wien). 2007; 149:1249–1253, discussion 1253.
Agid R, Terbrugge K, Rodesch G, Andersson T, Söderman M.Management strategies for anterior cranial fossa (ethmoidal) dural arteriovenous fistulas with an emphasis on endovascular treatment.J Neurosurg. 2009; 110:79–84.
Noguchi K, Kuwayama N, Kubo M, Kamisaki Y, Kameda K, Tomizawa G, et al.. Intracranial dural arteriovenous fistula with retrograde cortical venous drainage: use of susceptibility-weighted imaging in combination with dynamic susceptibility contrast imaging.AJNR Am J Neuroradiol. 2010; 31:1903–1910.
Nelson PK, Russell SM, Woo HH, Alastra AJ, Vidovich DV.Use of a wedged microcatheter for curative transarterial embolization of complex intracranial dural arteriovenous fistulas: indications, endovascular technique, and outcome in 21 patients.J Neurosurg. 2003; 98:498–506. doi: 10.3171/jns.2003.98.3.0498.
Al-Mahfoudh R, Kirollos R, Mitchell P, Lee M, Nahser H, Javadpour M.Surgical disconnection of the cortical venous reflux for high-grade intracranial dural arteriovenous fistulas.World Neurosurg. 2015; 83:652–656. doi: 10.1016/j.wneu.2014.12.025.
Chen CJ, Lee CC, Ding C, Starke RM, Chivukula S, Yen CP, et al.. Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review.J Neurosurg. 2015; 122:353–362.
Uchino K, Johnston SC, Becker KJ, Tirschwell DL. Moyamoya disease in Washington state and California. Neurology. 2005;65:956–58.
Baba T, Houkin K, Kuroda S. Novel epidemiological features of Moyamoya disease. J Neurol Neurosurgery Psychiatry. 2008;79:900–4.
Yamauchi T, Houkin k, Tada M, Abe H. Familial occurrence of Moyamoya disease. Clin Neurol Neurosurg. 1997;99(2 Suppl):S162–67.
Jea A, Smith ER, Robertson R, Scott RM. Moyamoya syndrome associated with Down syndrome outcome after surgical revascularization. Pediatrics. 2005;116(5):e694–701.
Katz DA, Marks MP, Napel SA, et al. Circle of Willis: evaluation with spiral CT, angiography, MRA and conventional angiography. Radiology. 1995;195:445–49.
Yamada I, Suzuki S, Matsushima Y. Moyamoya disease: comparison of assessment with MR angiography and MR imaging versus conventional angiography. Radiology. 1995;196:211–18.
Chang KH, Yi JG, Han MH, Kim IO. MR imaging findings of Moyamoya disease. Korean Med Sci. 1990;5:85–90.
Ibrahimi D, Tamargo R, Ahn E. Moyamoya disease in children. Childs Nerv Syst. 2010;26:1297–308.
Scott RM. Surgery of Moyamoya syndrome? Yes. Arch Neurol. 2001;58:128–29.
Golby AJ, Marks MP, Thompson RC, Steinberg GK. Direct and combined revascularization in pediatric Moyamoya disease. Neurosurgery. 1999;45:50–58.
Ishikawa T, Houkin K, Kamiyama H, Abe H. Effects of surgical revascularization on outcome of patients with pediatric Moyamoya disease. Stroke. 1997;28:1170–73.
Scott RM, Smith JL, Robertson RL, et al. Long-term outcome in children with Moyamoya syndrome after cranial revascularization by pial synangiosis. J Neurosurg. 2004;100(2 Suppl):142–49.
Arcalis N, Medrano S, Cuadrado M, Garcia D. [Capillary telangiectasia and developmental venous anomaly: a rare association]. Radiologia. 2013; 55(4): 353-356
Barr R, Dillon W, Wilson C. Slow-flow vascular malformations of the pons: capillary telangiectasias? AJNR Am J Neuroradiol. 1996; 17(1): 71-78
Flemming K, Brown R. The Natural History Of Intracranial Malformations. In Winn H, editor. Youmans Neurological Surgery. Sixth Edition ed. Philadelphia: Elsevier Saunders; 2011. p. 4030-4032.
Cohen J, Boitsova S, Moscovici S, Itshayek E. Concepts and controversies in the management of cerebral developmental venous anomalies. Isr Med Assoc J. 2010; 12(11): 703-706.
Pereira V, Geibprasert S, Krings T, Aurboonyawat T, Ozanne A, Toulgoat F, et al. Pathomechanisms of symptomatic developmental venous anomalies. Stroke. 2008; 39: 3201-3215.
Wilms G, Marchal G, Van Hecke P, Van Fraeyenhoven L, Decrop E, Baert A. Cerebral venous angiomas. MR imaging at 1.5 tesla. Neuroradiology. 1990; 32: 81-85.