Symptoms, management, and outcome of 13 cases of multiple cerebral arteriovenous malformations (MAVMs) are reported from the Centre Hospitalier de Bicetre, France. The age ranged from 6 months to 15 years. The incidence of MAVM among the pediatric population with brain AVMs was 16.9%. Congenital and acquired types were distinguished. Hemorrhage was the presenting symptom in 31%. Spontaneous regression occurred in 15%. Angiogenesis, or sprouting around a true AVM following hemorrhage, may account for some acquired MAVMs. Embolization was the most successful mode of treatment, but anatomical cure was rarely obtained. [1]

COMMENT. The rate of serious morbidity following a hemorrhage from an AVM is about 30% and the mortality is about 10%. AVMs in children are more apt to bleed than those in adults. Total excision seems the treatment of choice when feasible. (See Progress in Pediatric Neurology, Ed Millichap JG, Chicago, PNB Publishers, 1991). With multiple AVMs in the present study, embolization was preferred.