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OP-120 A rare complication after total excision of frontal AVM in the pediatric era: loss of vision in one eye
  1. Nur Aycan1,
  2. Abdurrahim Tas2,
  3. Serek Tekin3,
  4. Hande Cetin4,
  5. Serap Karaman1,
  6. Abdurrahman Aycan5
  1. 1Van Yuzuncu Yıl University, Faculty of Medicine, Department of Pediatrics
  2. 2Dicle University, Faculty of Medicine, Department of Neurosurgery
  3. 3Van Yuzuncu Yıl University, Faculty of Medicine, Department of Ophthalmology
  4. 4University of Health Sciences Van Training and Research Hospital, Hyperbaric O2 Therapy Unit, Van
  5. 5Van Yuzuncu Yıl University, Faculty of Medicine, Department of Neurosurgery


Aim Brain arteriovenous malformations (AVM)are defined as high-flow congenital masses consisting of nidus and drainage veins that may be of different sizes from the feeding arteries. They rarely present in childhood. Childhood AVM constitute 3–20%of all AVM. Although it is rare in childhood, 30–50% of intracranial hemorrhages in this age are caused by AVM. We aimed to present our case, which presented with complaints of headache, seizures and tendency to sleep, and resulted in total vision loss in the right eye as a result of central retinal artery stenosis that developed in the early period after longterm surgery.

Material and Method A 13-year-old patient was admitted to our hospital with complaints of sudden seizures and confusion and a referral request from an external center. The patient‘s GCS:14, she was prone to sleep. The patient, who had no motor deficit, had incontinence during the seizure. Other neurological examination findings were normal.

Abstract OP-120 Figure 1

Preoperative, intraoperative and postoperative images (figure 1). Preop Ct, MRI, DSA-Intraop Figure-Postop CT, MRI, Eye Anjiography.

Results CT-CT angiography and DSA angiography were performed on the patient. DSA angiography;It was reported as a frontal AVM with feeders from 4 places (A2, MCA)and 2 drainage veins. At the neuroradiology council, it was decided to undergo surgery (figure 1).

Conclusions The frontal AVM was completely excised after finding and clipping the feeders and drainage veins one by one with a microsurgery method that took approximately 20 hours. It was stated that the patient, who had no motor sensory deficit in the postoperative period, lost vision in the right eye on the 3rd day. As a result of eye consultation, occlusion was detected in the right retinal artery. It was recommended that the patient be given urgent hyperbaric O2 therapy. Patient, who received 10 sessions of hyperbaric O2 treatment, stated that vision loss in the right eye continued. To our knowledge, no cases of total retinal artery occlusion afterAVM surgery have been reported in the literature. It is due to vasospasm or microembolism in prolonged surgery is considered. Even if slightly successful results are obtained with hyperbaric O2 therapy, its treatment still remains a problem.

  • Pediatric age
  • AVM
  • Central Retinal Occlusion
  • Hyperbaric O2

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