Implementation of 3D modelling to improve understanding and conceptualisation of arteriovenous malformation (AVM) morphology for the execution of safe microsurgical excision of complex paediatric AVMs.

Introduction: Brain arteriovenous malformations (bAVMs) present complex challenges in neurosurgery, requiring precise pre-surgical planning. In this context, 3D printing technology has emerged as a promising tool to aid in understanding bAVM morphology and enhance surgical outcomes, particularly in pediatric patients. This study aims to assess the feasibility and effectiveness of using 3D AVM models in pediatric bAVM surgery.

Paediatric subarachnoid haemorrhage and severe vasospasm secondary to traumatic pseudoaneurysm of a fenestrated vertebral artery: a case report and review of the literature.

Paediatric intracranial aneurysms are rare entities accounting for less than 5% of all age intracranial aneurysms. Traumatic aneurysms are more common in children and have an association with anatomical variations such as arterial fenestrations. Here, we present a case of a child initially presenting with traumatic subarachnoid haemorrhage who returned to baseline and was discharged home only to return within 2 weeks with diffuse subarachnoid and intraventricular re-haemorrhage.

Neurosurgical management of proton beam therapy-induced moyamoya syndrome.

Objective: Proton beam therapy (PBT) is an increasingly used treatment modality for pediatric patients with brain tumors. Moyamoya syndrome (MMS) is well recognized as a complication of traditional photon radiotherapy, however its association with PBT is less well described. The authors discuss their initial experience with the neurosurgical management of MMS secondary to PBT in a large-volume pediatric neurovascular service.

Occult posterior inferior cerebellar artery dissection requiring endovascular treatment following pediatric head trauma: case report.

This is the eighth case report of a pediatric dissecting posterior inferior cerebellar artery aneurysm. The authors present the case of a 13-year-old boy who presented with posttraumatic posterior fossa subdural, subarachnoid, and intraventricular hemorrhage with hydrocephalus. Initial vascular imaging findings were negative; however, a high level of suspicion is necessary.

Management of haemorrhagic stroke secondary to arteriovenous malformations in childhood.

Aims: The aim of this study is to describe the outcome and management of all children who have presented with haemorrhagic stroke (HS) secondary to an arteriovenous malformation (AVM) at a single UK centre over a 13-year period.

Methods: All children with HS managed at our institution (2005-2018) were identified and those with underlying AVMs were studied. Clinical and imaging data were obtained from medical records.

Arterio-venous malformations of the ear: Description of distinct anatomical presentation and multidisciplinary management approach.

Background: Arterio-venous malformations (AVMs) of the ear are a rare entity and their management should be decided in a dedicated multidisciplinary team (MDT) setting. The aim of this study is to describe the distinct anatomical patterns of the auricular AVMs in our unit and propose a combined interventional radiological and surgical approach.

Materials And Methods: All consecutive patients presenting with AVMs of the ear and reviewed by the Vascular Anomalies MDT between 2014 and 2019 were included in this study.

Multiparametric Imaging for Presurgical Planning of Craniopagus Twins: The Experience of Two Tertiary Pediatric Hospitals with Six Sets of Twins.

Conjoined twins are rare and pose a challenge to radiologists and surgeons. Craniopagus twins, where conjunction involves the cranium, are especially rare. Even in large pediatric centers, radiologists are unlikely to encounter more than one such event in their medical careers.

Aspirin Preventing Occlusion after Coil Migration into the Distal Anterior Cerebral Artery.

Endovascular coil embolization of cerebral aneurysm is a common procedure for managing cerebral aneurysms. We present a rare case of immediate silent coil migration into the pericallosal artery, without distal occlusion, following successful embolization. Despite the entire coil sitting within the lumen of the artery, good distal flow was observed.

Atypical capillary malformations with subsequent diplegia: A difficult case of capillary malformation-arteriovenous malformation syndrome.

Capillary malformation-arteriovenous malformation syndrome (CM-AVM) is a rare condition associated with mutations in the genes RASA1 and EPHB4. We present a challenging case of CM-AVM in a 17-month-old boy with permanent diplegia from an undiagnosed arteriovenous malformation underlying a large atypical capillary malformation over the lower thoracic spine. This case demonstrates that clinicians should have a low threshold for neuroimaging in the context of new neurologic symptoms in patients with atypical capillary malformations.

Quantifying the Intra-Operative Hemodynamic Effects of Glue Embolization in Vein of Galen Malformations.

Vein of Galen malformation is a rare congenital pathological intracranial arteriovenous shunt which carries 30% risk of death before 28 days-of-age. Treatment is by high risk minimally invasive endovascular glue embolization of shunt feeding arteries under angiographic control. A tool to support intra-operative decision making would be useful.

Cross-sectional study of a United Kingdom cohort of neonatal vein of galen malformation.

Objective: Describe the course and outcomes in a UK national cohort of neonates with vein of Galen malformation identified before 28 days of life.

Methods: Neonates with angiographically confirmed vein of Galen malformation presenting to 1 of 2 UK treatment centers (2006-2016) were included; those surviving were invited to participate in neurocognitive assessment. Results in each domain were dichotomized into "good" and "poor" categories.

Presentation, course, and outcome of postneonatal presentations of vein of Galen malformation: a large, single-institution case series.

Aim: To describe presentation, clinical course, and outcome in postneonatal presentations of vein of Galen malformation (VGM).

Method: Children older than 28 days presenting with VGM (from 2006-2016) were included. Notes/scans were reviewed.

Reduction of severe visual loss and complications following intra-arterial chemotherapy (IAC) for refractory retinoblastoma.

Background: Intra-arterial chemotherapy (IAC) for retinoblastoma has been documented as causing visual loss and ocular motility problems. A lack of safety data has precluded its acceptance in all centres.

Methods: Retrospective cohort study of patients with retinoblastoma from 2013 to 2015 who had a healthy foveola and relapsed following systemic chemotherapy.

Multiple cerebral aneurysms secondary to cardiac myxoma.

A 45-year-old lady presented with transient ischemic attack symptoms. Subsequent CT and DSA revealed multiple fusiform dilatations of cerebral vessels. A search for sources of emboli led to an atrial myxoma being found on echocardiogram.

The treatment of a dural carotid cavernous fistula (CCF) using Onyx via a transorbital approach: a technical note.

We report the successful case of embolisation of a Barrow D (White et al. in Am J Neuroradiol 28:1415-1417, 2007) dural carotid cavernous fistula (CCF) with bilateral external carotid artery and internal carotid arterial supply, using a direct percutaneous transorbital approach with the embolic agent Onyx. In particular, we highlight the properties of Onyx which make it suitable to treat the multi-compartmental nature of CCFs.

Fatal hemorrhage after attempted treatment of a basilar artery stenosis. Case report.

Interventional treatment of severe intracranial stenoses using angioplasty and stent placement carries a significant risk of severe adverse events. These events are frequently caused by the intraarterial dilation but may also be precipitated by other causes related to the procedure. The authors describe a fatal subarachnoid hemorrhage during the treatment of a basilar artery (BA) stenosis caused by a vascular rupture distant from the site of angioplasty.

Abciximab for thrombolysis during intracranial aneurysm coiling.

Introduction: Thrombotic events are a common and severe complication of endovascular aneurysm treatment with significant impact on patients' outcome. This study evaluates risk factors for thrombus formation and assesses the efficacy and safety of abciximab for clot dissolution.

Materials And Methods: All patients treated with abciximab during (41 patients) or shortly after (22 patients) intracranial aneurysm coil embolisation were retrieved from the institutional database (2000 to 2007, 1,250 patients).

A prospective audit of 300 consecutive young women with an acute presentation of right iliac fossa pain.

Introduction: A prospective study of 300 women of child-bearing age presenting with right iliac fossa pain was carried out to determine what proportion had appendicitis and whether active observation resulted in a delay in diagnosis to the detriment of the patient.

Patients And Methods: Data were prospectively collected for 300 consecutive women of childbearing age referred with right iliac fossa pain to general surgeons at a district general hospital.

Results: After clinical assessment, 71 were discharged home immediately.