Fortunately nowadays this condition can be treated and children stand a very good chance of a normal development. In the past neurosurgeons have tried to obliterate the abnormal communications by tying off the shunts, but results and outcomes by this technique were often very bad. Nowadays, it is possible to enter the blood vessels by travelling with tiny plastic tubes up from the baby’s artery in the leg and depositing a glue in the abnormal shunt to shut it off. Sometimes several procedures are needed to shut off all the communications. This is usually done over a period of months whilst the baby is under two years of age.
Who can treat it?
This is highly specialised work and very few people have much expertise in its management. Many doctors who face the challenge of such treatment have only ever seen one or two cases and, although they have experience in the guidance of catheters in adults and sometimes children, there are extremely few who have accumulated good experience.
Good results depend on understanding the disease and assessing the technical and medical challenges. Good management depends on excellent interdisciplinary teamwork with anaesthetists, intensivists and paediatric neurologists. This experience has only been accumulated in one or two units world wide.