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OC025: Diagnosis and prognosis of ischemic and hemorrhagic lesions of the fetal brain

The exceptional pial AVMs that present in the neonatal period, may be revealed by the stressful haemodynamic changes that occur perinatally, triggering the emergence of a subpial venous endothelial cell dysfunction. This shunt will create specific stress triggers on the rest of the vasculature and become rapidly apparent clinically and morphologically. Other subpial endothelial veins defects may be triggered long after birth by different causes and give rise to the more classic AVMs. Vascular Malformation is a very ambiguous denomination for the cerebral AV shunts found within the paediatric and adult populations. Unless we accept the concept of embryonic, foetal, postnatal and acquired AV malformations, which would focus on the timing of clinical expression, we would rather use the term AV shunt. The age of a given lesion will hardly be determined even if the timing of the causative trigger can be found. Traditional classifications of brain AVMs encompass different types of diseases with differences in timing and nature of the initial event. The most eloquent illustration of the congenital origin and post natal appearance of brain AVM is illustrated by CAMS.