Adjuvant and Alternate Therapies for Cerebral Arteriovenous Malformations in Children

Medical

• No curative treatments: Currently there are no accepted medical treatments for the cure of AVMs in children.  Medical therapies are focused on the abrogation of symptoms (headache, antiepileptic medication, blood pressure control, etc.).

Radiation Therapy

• Radiosurgery for lesions smaller than 3 cm: Conventional fractionated radiation is not helpful in most AVMs.  In contrast, stereotactic radiosurgery offers cure rates of up to 90% in lesions smaller than 3 cm.  This approach is beneficial for surgically inaccessible lesions or for lesions in patients who are high-risk surgical candidates.  Shortcomings of this approach include a delay of up to 3 years for lesion obliteration and exposure to radiation in children. Radiation has increased risk in younger populations, making its application less appealing in children under 3 years of age.