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CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0043-1776388
Case Report

Cerebral Arteriovenous Malformation in a Pediatric Patient with Severe Systemic Hypertension

Divya Rani
1   Department of Anaesthesiology and Critical Care, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India
,
Meenakshi Kumar
1   Department of Anaesthesiology and Critical Care, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India
,
Mansi Jain 
1   Department of Anaesthesiology and Critical Care, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India
,
Anjali Kochhar
1   Department of Anaesthesiology and Critical Care, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India
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Abstract

Arteriovenous malformations (AVMs) are a tangle of blood vessels that connects arteries and veins in which the feeding arteries are directly connected to the venous channels. Cerebral AVM needs special consideration due to high risk of bleeding and neurological deficit associated with morbidity and mortality. In pediatric population, prevalence rate of cerebral AVM is 0.02%. The systemic hemodynamic changes are seen more frequently with peripheral AVM, whereas its association with cerebral AVM is rare. We report a rare case of cerebral AVM in a 12-year-old child with severe systemic hypertension and electrocardiogram changes of biventricular hypertrophy planned for surgical resection of AVM in view of intracerebral bleed. This case illustrates the importance of detailed cardiac, renal, and endocrine evaluation in children with cerebral AVM with systemic hypertension and left ventricular hypertrophy to rule out other causes of systemic hypertension prior to surgery.

Keywords

cerebral arteriovenous malformation - severe systemic hypertension - left ventricular hypertrophy - pediatric - general anesthesia - perioperative complications


Publication History

Article published online:
28 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Ohanisian L, Sidley A, Wirth J. An unusual presentation of arteriovenous malformation in a pediatric patient. Cureus 2019; 11 (03) e4209
    PubMedGoogle Scholar
  • 2 Epidemiology of Cerebral Arteriovenous Malformations in Children - The ISPN Guide to Pediatric Neurosurgery. Accessed October 4, 2023 at: https://www.ispn.guide
    PubMed
  • 3 LoPresti MA, Ravindra VM, Pyarali M. et al. Pediatric intracranial arteriovenous malformations: a single-center experience. J Neurosurg Pediatr 2020; 25 (02) 151-158
    CrossrefPubMedGoogle Scholar
  • 4 Di Rocco C, Tamburrini G, Rollo M. Cerebral arteriovenous malformations in children. Acta Neurochir (Wien) 2000; 142 (02) 145-156 , discussion 156–158
    CrossrefPubMedGoogle Scholar
  • 5 Warren JV, Nickerson JL, Elkin DC. The cardiac output in patients with arteriovenous fistulas. J Clin Invest 1951; 30 (02) 210-214
    CrossrefPubMedGoogle Scholar
  • 6 El-Ghanem M, Kass-Hout T, Kass-Hout O. et al. Arteriovenous malformations in the pediatric population: review of the existing literature. Intervent Neurol 2016; 5 (3-4): 218-225
    CrossrefPubMedGoogle Scholar
  • 7 Flynn JT, Kaelber DC, Baker-Smith CM. et al; Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017; 140 (03) 1904
    CrossrefPubMedGoogle Scholar
  • 8 Göknar N, Çalışkan S. New guidelines for the diagnosis, evaluation, and treatment of pediatric hypertension. Turk Pediatri Ars 2020; 55 (01) 11-22
    PubMedGoogle Scholar
  • 9 Riley M, Hernandez AK, Kuznia AL. High blood pressure in children and adolescents. Am Fam Physician 2018; 98 (08) 486-494
    PubMedGoogle Scholar
  • 10 Misra S. Systemic hypertension and non-cardiac surgery. Indian J Anaesth 2017; 61 (09) 697-704
    CrossrefPubMedGoogle Scholar
  • 11 Meshram TM, Ramachandran R, Trikha A, Rewari V. Haemodynamic responses following orotracheal intubation in patients with hypertension—Macintosh direct laryngoscope versus Glidescope® videolaryngoscope. Indian J Anaesth 2021; 65 (04) 321-327
    CrossrefPubMedGoogle Scholar
  • 12 Shang W, Li Y, Ren Y, Yang Y, Li H, Dong J. Nephrolithiasis and risk of hypertension: a meta-analysis of observational studies. BMC Nephrol 2017; 18 (01) 344
    CrossrefPubMedGoogle Scholar
  • 13 Fujishima M, Tanaka K, Omae T. Cerebral arteriovenous malformation as a cause of cardiac hypertrophy in adults. Jpn Heart J 1972; 13 (06) 471-477
    CrossrefPubMedGoogle Scholar
  • 14 Saavedra H, Toncel C, Delgado V, Borré O, Rojas-Suárez J. Reversible pulmonary hypertension and high-output heart failure triggered by pregnancy in a patient with congenital arteriovenous malformation: a case report. Obstet Med 2019; 12 (02) 97-99
    CrossrefPubMedGoogle Scholar