Tap on and choose 'Add to Home Screen' to create a shortcut app

Tap on and choose 'Add to Home Screen/Install App' to create a shortcut app

Recovery for Arteriovenous Malformations in Children

This page was last updated on January 25th, 2023

Postoperative Orders 

  • VS: Continuous blood pressure, heart rate, and oxygenation monitoring; strict monitoring of inputs and outputs
  • Blood pressure: Normotensive to slightly (<5%) hypotensive to reduce risk of perfusion breakthrough in high-flow lesions
  • Fluids: Isotonic IV fluids at maintenance levels (usually normal saline)
  • CSF drainage: Keep external ventricular drain at 20 cm above external auditory meatus and monitor output per physician.
  • Diet: NPO
  • HOB: Bed rest, head of bed at 30 degrees
  • Nursing: Maintain age-appropriate normotension, oxygenation.  Repeat neurological examination hourly and report changes.
  • Medications: Antihypertensives (labetolol or nipride), antiepileptics, antibiotic (if EVD inserted), stool softener, multivitamin, pain management (usually short-acting narcotics such as morphine) Are the author’s preferred list.  Avoid aspirin and any long-acting sedating agents unless specific orders are provided to the contrary.

Postoperative Morbidity

  • Perfusion breakthrough: Normal perfusion pressure breakthrough is a phenomenon that is thought to occur after resection of high-flow AVMs in which the blood previously transmitted through the AVM is redirected to smaller, normal vasculature after the AVM has been removed, with subsequent inability of the vessels to handle the increased flow.  This can result in brain swelling, increased ICP, seizure, neurological dysfunction, or hemorrhage.  The problem may be minimized by staged preoperative embolization and rigorous blood pressure control postoperatively.

Your donations keep us going

The ISPN Guide is free to use, but we rely on donations to fund our ongoing work and to maintain more than a thousand pages of information created to disseminate the most up-to-date knowledge in the field of paediatric neurosurgery.

By making a donation to The ISPN Guide you are also indirectly helping the many thousands of children around the world whose treatment depends on well-informed surgeons.

Please consider making a donation today.

Use the app

The ISPN Guide can be used as a standalone app, both on mobile devices and desktop computers. It’s quick and easy to use.

Fully featured

Free registration grants you full access to The Guide and host of featured designed to help further your own education.

Stay updated

The ISPN Guide continues to expand both in breadth and depth. Join our mailing list to stay up-to-date with our progress.