{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:35Z","timestamp":1792787315593,"version":"4.5.0"},"reference-count":28,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82101369"],"award-info":[{"award-number":["82101369"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science Program for Fostering Young Scholars","award":["QNPY2020009"],"award-info":[{"award-number":["QNPY2020009"]}]},{"name":"Natural Science Foundation of Beijing","award":["7222081"],"award-info":[{"award-number":["7222081"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2022,12,4]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pial arteriovenous fistulas (PAVFs) are rare and mostly observed in children. However, the overall angioarchitecture, clinical features, treatments and long-term prognosis for pediatric patients remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data of consecutive 42 pediatric PAVFs were documented and analysed. According to the differences of age distribution and clinical features, they were split into a younger group (\u22643 years old; 20 cases) and an older group (3\u201314 years old; 22 cases).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Their mean age was 4.9\u00b13.9 years, and the mean preoperative modified Rankin Scale (mRS) score was 1.64\u00b11.57. Fourteen patients (33.3%) were asymptomatic, followed by epilepsy (21.4%), intracranial haemorrhage (16.7%), hydrocephalus (9.5%), developmental delay (7.1%), intermittent headache (7.1%) and congestive heart failure (4.8%). Annual bleeding rate and rebleeding rate before treatment reached 3.86% and 3.17%. Poor venous drainage including sinus dynamic obstruction (21 cases, 50.0%) and sinus occlusion (17 cases, 40.48%) were found with high frequency among these patients. Finally, 33 cases were cured (78.57%), and 4 cases faced surgery-related complications (9.52%). During 24\u2013140 months\u2019 follow-up, the mean mRS score reduced to 0.57\u00b10.40. However, only 22 cases (52.38%) recovered to absolutely normal, and poor venous drainage was the risk factor for patients\u2019 incomplete recovery (p=0.028, Exp(B)=14.692, 95% CI 1.346 to 160.392). Compared with the older group, younger group showed more chronic symptoms, more secondary pathological changes, more times treatment and worse prognosis (p=0.013, 0.002, 0.000 and 0.032, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric PAVF has different angioarchitectures, clinical features and prognoses in different age groups. Poor venous drainage is an important factor leading to poor prognosis, and it accounts for incomplete recovery in nearly half of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/svn-2022-001979","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T10:45:29Z","timestamp":1673001929000},"page":"292-300","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Angioarchitecture and prognosis of pediatric intracranial pial arteriovenous fistula"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2620-3389","authenticated-orcid":false,"given":"Jingwei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"National Center for Neurological Disorders, Beijing, China"},{"name":"China International Neuroscience Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenlong","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"Department of Neurosurgery, Affiliated Hospital of Beihua University, Jilin province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxing","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"National Center for Neurological Disorders, Beijing, China"},{"name":"China International Neuroscience Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"National Center for Neurological Disorders, Beijing, China"},{"name":"China International Neuroscience Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing United Family Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisong","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Haidian Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinglong","family":"Zhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"National Center for Neurological Disorders, Beijing, China"},{"name":"China International Neuroscience Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"National Center for Neurological Disorders, Beijing, China"},{"name":"China International Neuroscience Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8740-6828","authenticated-orcid":false,"given":"Hongqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"},{"name":"National Center for Neurological Disorders, Beijing, China"},{"name":"China International Neuroscience Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"2025081709464239000_8.4.292.1","first-page":"747","article-title":"Transarterial occlusion of solitary intracerebral arteriovenous fistulas","volume":"10","author":"Halbach","year":"1989","journal-title":"AJNR Am J 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Cerebrospinal fluid absorption. In: Kapp J , Schmideck H , eds. The cerebral venous system and its disorders. New York: Grune and Stratton, 1984: 251\u201374."},{"key":"2025081709464239000_8.4.292.20","doi-asserted-by":"crossref","unstructured":"Lasjaunias P , ter Brugge K , Berenstein A . Surgical Neuroangiography 3 clinical and interventional aspects in children. 2nd edn. Berlin: Springer, 2006.","DOI":"10.1007\/978-3-540-68320-9"},{"key":"2025081709464239000_8.4.292.21","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/ped.13159","article-title":"Endovascular treatment of pediatric intracranial arteriovenous shunt","volume":"59","author":"Niimi","year":"2017","journal-title":"Pediatr Int"},{"key":"2025081709464239000_8.4.292.22","unstructured":"Lasjaunias P , Ter Brugge KG , Berenstein A . Technical Aspects of Surgical Neuroangiography. In: Surgical Neuroangiography. 2nd edn. 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