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Contemporary retrospective studies were systematically reviewed to summarize outcomes across treatment modalities and to characterize interstudy variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE was searched over the past decade for retrospective pediatric intracranial bAVM cohorts. Eligible studies reported management with observation\/conservative care, endovascular embolization, microsurgical resection, stereotactic radiosurgery (SRS), or multimodality therapy. Screened studies had data extracted using a standardized form. Outcomes included obliteration, hemorrhage (first presentation and post-treatment), functional outcomes, complications, and recurrence after apparent cure. Treatment categories were harmonized into mutually exclusive groups for descriptive synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 113 identified records, 20 retrospective cohort studies met the inclusion criteria. Hemorrhage was the most common presentation. Across cohorts reporting Spetzler\u2013Martin (SM) grade, low-grade lesions (SM I\u2013II) comprised 740 patients (44.1%), SM III 645 (38.4%), and SM IV\u2013V 293 (17.5%). Treatment strategies varied substantially; among 1,973 classifiable patients, cohorts reported microsurgery-only, SRS-only, endovascular-only, multimodality, and conservative approaches. Definitions of obliteration and assessment methods were inconsistent (DSA-confirmed vs. MRI-based). Microsurgical series reported obliteration rates of 81%\u2013100% in selected populations (unweighted mean\u2009~\u200993% across reporting cohorts), whereas SRS-only cohorts demonstrated obliteration rates of 51%\u201368.5% in the three largest unselected pediatric series (range 36%\u201384% across all SRS-inclusive cohorts), with latency-period hemorrhage rates of approximately 1.1%\u20133.2% per series. Recurrence after apparent cure was reported in 7 cohorts, with rates ranging from &lt;\u20091% to 29%, occurring years after angiographic obliteration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Contemporary retrospective pediatric bAVM data indicate that modality-specific outcomes are strongly influenced by lesion selection, outcome definitions, and follow-up duration. Recurrence after apparent cure is not uncommon and supports explicit long-term surveillance. Standardized definitions and harmonized reporting are needed to improve interpretability and comparative inference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10143-026-04346-2","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:33:17Z","timestamp":1779935597000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of pediatric brain arteriovenous malformation: a systematic review of retrospective studies"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5951-8371","authenticated-orcid":false,"given":"Helbert","family":"de Oliveira Manduca Palmiero","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberval","family":"Gadelha Figueiredo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"issue":"3","key":"4346_CR1","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2014.6.FOCUS14250","volume":"37","author":"IJ Abecassis","year":"2014","unstructured":"Abecassis IJ, Xu DS, Batjer HH, Bendok BR (2014) Natural history of brain arteriovenous malformations: a systematic review. 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This study is a literature review based entirely on previously published data and does not involve new human participants, animals, or patient information.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable. This study relied exclusively on previously published studies and did not require patient-informed consent, as no new human or critical data were collected.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors are the owners of the illustrations and give consent for publication in this journal.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}],"article-number":"424"}}