Background: Although Pediatric Arteriovenous malformations (AVMs) are relatively rare, they carry a higher rate of rupture in adults. Pediatric AVMs could also be present with recurrent seizures or headaches. Endovascular embolization is usually achievable in pediatric AVMs cases with increasing complete obliteration rates, especially in cases with small AVMs.

Patients, and Methods: within 9 years, 57 patients, including 37 females (64.91%) with age ranging between 4-18 years, were admitted to 3 centers. 54 (94.73%) patients presented with intracranial hemorrhage and 3 patients (5.26%) presented with fits. All patients were subjected to clinical and radiological assessment Endovascular embolization is done for all cases in one or two sessions. Complementary treatment including microsurgery , and radiosurgery . Clinical and radiological follow-ups were done for all patients for at least one year.

Results: All patients were treated with endovascular embolization as primary modality of treatment. 30 patients achieved total obliteration of AVMs in one session and 8 patients in 2 sessions. After endovascular embolization; 7 patients underwent microsurgical excision, and another 12 patients were referred to radiosurgery. All patients had no permanent morbidity or mortality related to embolization technique. 8 patients had transient neurological complication.

Conclusions: Endovascular embolization is a safe and an effective technique as a single modality in management of pediatric AVMs. It has extended the role of microsurgery and radiosurgery to treat previously no