Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Child's Nervous System
Published in: Child's Nervous System 9/2023

12-05-2023 | Angiography | Case Report

Embolization of midbrain arteriovenous malformation fed by the artery of Percheron in a child, the first case report and literature review

Authors: Jun Tang, Lusheng Li, Yudong Zhou, Xuan Zhai, Ping Liang

Published in: Child's Nervous System | Issue 9/2023

Login to get access

Abstract

Background

Artery of Percheron (AOP) as main feeder artery of arteriovenous malformation (AVM) is extremely rare. Two cases of thalamic AVM fed by AOP have been reported to date and only one AVM been removed by microsurgery when attempt of intervention embolization failed. Midbrain AVM fed by AOP has not been reported yet.

Case presentation

Here, we presented the first successful embolized case of midbrain AVM supplied by the AOP in a 10-year-old boy, who suffered dual oculomotor nerve palsy and secondary hemorrhage before embolization. During endovascular embolization, selective angiography by 1.2 Fr. Magic microcatheter showed an intranidal aneurysm located on the distal AOP. Two injections of a 1:4 ratio mixture of NBCA-MS completely occlude the nidus and intranidal aneurysm with no complications occurred. The child recovered well and the oculomotor deficits improved.

Conclusion

This case highlighted that AOP is a clinically significant branch associated with AVM in midbrain and thalamus. Moreover, intervention embolization of midbrain AVM fed by AOP is a considerable therapeutic strategy.
Literature
1.
Percheron G (1973) The anatomy of the arterial supply of the human thalamus and its use for the interpretation of the thalamic vascular pathology. Zeitschrift Fur Neurologie 205(1):13
2.
Kheiralla O, Alghamdi S, Aljondi R et al (2021) Artery of Percheron infarction: a characteristic pattern of ischemia and variable clinical presentation: a literature review. Current Med Imaging 17:669–674CrossRef
3.
Chen Y, Li R, Ma L et al (2021) Long-term outcomes of brainstem arteriovenous malformations after different management modalities: a single-centre experience. Stroke Vas Neurol 6:65–73CrossRef
4.
Han SJ, Englot DJ, Kim H et al (2015) Brainstem arteriovenous malformations: anatomical subtypes, assessment of “occlusion in situ” technique, and microsurgical results. J Neurosurg 122:107–117CrossRefPubMedPubMedCentral
5.
Spetzler RF, Ponce FA (2011) A 3-tier classification of cerebral arteriovenous malformations. Clinical article. J Neurosurg 114:842–849CrossRefPubMed
6.
Motegi H, Terasaka S, Shiraishi H et al (2014) Thalamic arteriovenous malformation fed by the artery of Percheron originating from the contralateral posterior cerebral artery in a child. Child’s Nerv Syst : ChNS : Official J Int Soc Pediatr Neurosurg 30:1313–1315CrossRef
7.
Zhang M, Feng Z, Yu W et al (2020) Artery of Percheron as a rare feeder of hemorrhagic thalamic arteriovenous malformation: a case report and literature review. Int J General Med 13:771–774CrossRef
8.
Lin PC, Lee CW, Liu HM et al (2018) Acute infarction in the artery of Percheron distribution during cerebral angiography: a case report and literature review. J Radiol Case Rep 12:1–9CrossRefPubMedPubMedCentral
9.
Di Rocco C, Tamburrini G, Rollo M (2000) Cerebral arteriovenous malformations in children. Acta Neurochirurgica 142:145–156; discussion 156–148
10.
Sanchez-Mejia RO, Chennupati SK, Gupta N et al (2006) Superior outcomes in children compared with adults after microsurgical resection of brain arteriovenous malformations. J Neurosurg 105:82–87PubMed
11.
Solomon RA, Stein BM (1986) Management of arteriovenous malformations of the brain stem. J Neurosurg 64:857–864CrossRefPubMed
12.
13.
Gross BA, Duckworth EA, Getch CC et al (2008) Challenging traditional beliefs: microsurgery for arteriovenous malformations of the basal ganglia and thalamus. Neurosurgery 63:393–410; discussion 410–391
14.
Nozaki K, Hashimoto N, Kikuta K et al (2006) Surgical applications to arteriovenous malformations involving the brainstem. Neurosurgery 58:ONS-270–278; discussion ONS-278–279
Metadata
Title
Embolization of midbrain arteriovenous malformation fed by the artery of Percheron in a child, the first case report and literature review
Authors
Jun Tang
Lusheng Li
Yudong Zhou
Xuan Zhai
Ping Liang
Publication date
12-05-2023
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 9/2023
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-023-05978-1

Other articles of this Issue 9/2023

Child's Nervous System 9/2023 Go to the issue

Case Report

Concurrent medulloblastoma and cardiac fibroma: a rare presentation of Gorlin-Goltz syndrome

Case-based Review

A unique case of intracranial collision tumor composed of ganglioglioma WHO gr I and supratentorial ependymoma WHO gr III: case-based literature review

Original Article

Trends in the early care of infants with myelomeningocele in the United States 2012–2018

Original Paper

Neuroendoscopy in the management of pineal region tumours in children

Letter to the Editor

A clinical clue toward recognition of split cord malformation type-I resembling meningocele in neonates

Case Report

Transorbital neuroendoscopy-assisted resection of a giant optic pathway glioma in a neonate