Follow-up for Dural Arteriovenous Fistulas in Children

 

Frequency of Office Visits

  • Scheduling Follow up: The first follow-up visit can be scheduled with Neurosurgery 10 days after surgery in order to check the wound status and for possible suture/staple removal. Future follow-ups are at 1 month, 6 months and yearly.

Frequency of Imaging

  • Annual MRI: Arrangements should be made for serial follow-up because these lesions have a great potential for recurrence. An initial imaging study can be scheduled at 6 months (MRI/MRA/MRV). If two consecutive studies rule out recurrence, in order to avoid radiation exposure in children, a yearly MRI/MRA/MRV can be performed for about 5 years in clinically-stable treated DAVFs. After that, imaging can be further spaced in time.
  • Angiography if evidence of recurrence: In cases of clinical or radiological recurrence, additional angiography should be obtained.

Other Required Investigations

  • Hematology consult: For hypercoagulable states a hematology consult is recommended.
  • Neuropsychological testing: Neuropsychological testing could be helpful, especially if there is a preoperative study for comparison.