Early neonatal adaptation is a critical stage of the transition to extrauterine life, requiring early verification of markers of severe conditions to reduce the risk of adverse outcomes. The aim of the study . To assess the incidence and prognostic significance of multiple organ failure (≥2 points) using the NEOMOD scale in premature monochorionic diamniotic twins depending on the course of the antenatal period, and to describe the structure of multiple organ dysfunction in the first hours of life. Materials and methods . We retrospectively analyzed clinical and laboratory signs of multiple organ dysfunction in premature monochorionic twins aged 220–366 weeks. Based on the presence/absence of antenatal complications, the following groups were identified: twin-to-twin transfusion syndrome (n=223); selective fetal growth restriction syndrome (n=168); and uncomplicated antenatal period (n=357). The groups were comparable for the main parameters. Results . Multiple organ failure, assessed using the modified NEOMOD (Neonatal Multiple Organ Dysfunction) scale, was more frequently recorded in cases of antenatal complications (79,3%) compared to uncomplicated pregnancies (49,9%; p<0,001). Severe multiple organ failure (≥5 points) was more common in twins who had twin-to-twin transfusion syndrome (p<0,001). The highest NEOMOD values (9 points) were observed in infants who died within the first day of life. Conclusion . The risk and severity of multiple organ failure in monochorionic twins are associated with extremely low birth weight, perinatal infection, and specific antenatal complications. The leading contribution to the severity of the condition is made by respiratory, microcirculatory and hemodynamic disorders, which determine the level of NEOMOD and the length of stay in the neonatal intensive care unit.
Cardiorenal syndrome is a disorder of the heart and kidneys, in which acute or chronic damage to one of these organs can cause acute or chronic damage to the other organ. Despite existing research, the problem of cardiorenal syndrome remains insufficently studied. Cardiorenal syndrome in children has unique pathogenetic mechanisms and clinical manifestations that require special attention. There is also a lack of standardized diagnostic approaches in children. The article presents various approaches to classification, the evolution of the concept of cardiorenal relationships, and the current understanding of the pathogenesis of cardiorenal syndrome.
Meningitis is a devastating disease for which appropriate initial treatment improves outcome. Management strategies are based on the etiology, which is most commonly bacterial or viral. However, prompt detection of the etiologic agent is not possible in all cases; therefore, the investigation of additional early differential diagnostic markers, such as interleukins, remains relevant. The aim of the study. To determine the differential diagnostic value of cerebrospinal fluid/serum ratios of interleukins 6, 8, 10 in purulent bacterial and viral meningitis in children. Materials and Methods. This prospective study enrolled 63 children, divided into three groups: bacterial meningitis (n=20), viral meningitis (n=17), and a control group (n=26). Concentrations of albumin, interleukins 6, 8, 10 were evaluated in cerebrospinal fluid and serum samples obtained in parallel on the day of admission. Cerebrospinal fluid/serum ratios (QAlb and QIL) were calculated. Receiver operating characteristic (ROC) curve analysis was performed with estimation of the area under the curve (AUC) and determination of optimal cut-off values. A predictive model was developed with binary logistic regression. Results. Interleukin 6 concentrations in cerebrospinal fluid (AUC = 0.982) and serum (AUC = 0.991), serum interleukin 10 (AUC = 0.965), and QIL10 (AUC = 0.953; sensitivity = 95.0%, specificity = 76.5%) demonstrated high diagnostic accuracy in differentiating bacterial from viral meningitis. Combining QAlb and QIL10 in the predictive model equation increased sensitivity (100%) and specificity (88.2%). A possible mechanism of intrathecal regulation of inflammation in the early stages of meningitis is proposed. In bacterial meningitis, only pro-inflammatory interleukins 6 and 8 are synthesized intrathecally, resulting in neutrophilic pleocytosis. In viral meningitis, intrathecal production of interleukins 6 and 8 and anti-inflammatory interleukin 10 inhibiting neutrophil recruitment into the cerebrospinal fluid leads to mixed or lymphocytic pleocytosis. Conclusion. Evaluation of interleukin 6 concentration in cerebrospinal fluid and application of the predictive formula incorporating QAlb and QIL10 enables differentiation between bacterial and viral meningitis at the early stages of the disease.
Coronary heart disease, which is caused by coronary atherosclerosis, is the largest contributor to cardiovascular mortality. Atherosclerosis originates in childhood. This article presents data on the prevalence and etiology of familial hypercholesterolemia, characterized by high levels of low-density lipoprotein cholesterol. This leads to the onset of atherosclerotic vascular disease in childhood and the development of myocardial infarction in the second or third decade of life. The disease is asymptomatic for a long time, especially in childhood, and therefore its detection rate is less than 1%. Diagnostic criteria and genetic aspects of the disease are outlined, and various screening options for hypercholesterolemia are discussed. A strategy for the primary prevention of cardiovascular disease is presented, and current drug therapy options are discussed. Indications for the use of statins, cholesterol absorption inhibitors, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are presented. It is demonstrated that early detection of familial hypercholesterolemia in children will facilitate the timely initiation of lipid-lowering therapy, which will halt the progression of atherosclerosis and prevent the development of coronary heart disease.
The increasing incidence of speech development disorders is one of the most significant issues in pediatrics and child neurology. The aim of the study . To identify statistically significant differences in the influence of perinatal risk factors on the occurrence of specific and nonspecific speech development disorders. Materials and methods . The longitudinal study included 525 children with specific and nonspecific speech development disorders (324 boys, 201 girls, born between 2005 and 2021). The group with specific speech disorders consisted of 322 children, while the group with comorbid disorders included 203 children. The authors analyzed anamnesis data related to the prenatal and perinatal periods of development, the results of neurological examinations during the first year of life, and their relationship with data on the children's motor and subsequent speech development. A comparative analysis was conducted in the groups. Results . Statistically significant differences (higher incidence in the group with comorbid disorders) were revealed for the following risk factors: in vitro fertilization (p=0.02); threatened miscarriage (p<0.00001), especially in the third trimester (p=0.0002); infectious diseases during pregnancy (p<0.00001), especially acute respiratory viral infections (p<0.00001) and influenza (p=0.002); sexually transmitted diseases (p=0.001); antibiotic therapy in the 3rd trimester of pregnancy (p=0.04); cerebral ischemia in the neonatal period (p=0.04); perinatal damage to the central nervous system in the form of pyramidal insufficiency syndrome (p<0.00001) during the first year of life; hyperbilirubinemia (p<0.00001), including prolonged variant, with bilirubin levels above 200 µmol/L (p<0.00001). Conclusion . Pediatricians and neurologists should be vigilant in identifying these risk factors when assessing the development of a child under three years of age, since they may be harbingers of further delays in psychomotor development, and promptly refer children for neuropsychological diagnostics for the purpose of early intervention in the habilitation process.
Cardiovascular diseases are one of the most common causes of disability and mortality in the young working age population worldwide. Atherosclerosis is a key pathological process that leads to early cardiovascular catastrophes, including heart attacks, strokes and ischemic heart disease. Timely diagnosis of dyslipidemia can ensure the initiation of effective treatment and prevention. Hereditary forms of lipid metabolism disorders are particularly dangerous and require close attention, starting from childhood. One of the effective methods for diagnosing dyslipidemia is screening of blood cholesterol levels. The world practice includes several types of screening, but the most commonly used are selective and universal. In the Russian Federation, until now, measurement of cholesterol levels has not been included in any examination of a child as part of dispensary monitoring. The new resolution pays special attention to children from risk groups and the measurement of total cholesterol from capillary blood at the ages of 6 and 10 years.
Primary sclerosing cholangitis (PSC) is a progressive, chronic liver disease characterized by destruction of the intra- and extrahepatic bile ducts. Much remains unknown about primary sclerosing cholangitis, including its underlying cause. However, available data suggest a multifactorial etiology, where the interaction of a combination of genetic predisposition, environmental factors, gut microbiome imbalance, and immune dysregulation triggers activation of cholangiocytes and peribiliary myofibroblasts that function in concert to cause progressive fibroinflammatory destruction of the bile ducts. This article discusses the association of primary sclerosing cholangitis and inflammatory bowel disease and diagnostic methods for these conditions.
The search for highly sensitive biomarkers and predictors of early diagnostics of renal damage in chronic progressive kidney diseases is due to the increasing incidence of chronic kidney disease in children. The article presents our own scientific results on the clinical and paraclinical characteristics of chronic kidney disease in children and the development of pathogenetic markers for the diagnosis and prognosis of chronic kidney disease in childhood. Based on the assessment of risk factors for progression, inflammatory mediators and fibrogenesis, modern pathogenetic approaches to the early diagnostics of chronic kidney disease in children are scientifically substantiated. The study demonstrates the high diagnostic value of assessing the kidney injury molecule 1 (KIM-1), vascular endothelial growth factor - VEGF, monocyte chemoattractant protein-1 (MCP-1) in combination with the level of interleukin 18 (IL-18) for identifying the initial stages of chronic kidney disease in childhood.
Traditional Chinese Medicine methods such as acupuncture, reflexology massage, and others, as independent interventional measures, demonstrate a positive effect in improving muscle tone, motor functions, and adaptation to daily living conditions in children with cerebral palsy. The aim of the study . To enhance the effectiveness of comprehensive rehabilitation for children with spastic forms of cerebral palsy by incorporating Gua Sha therapy and reflexotherapy into the medical rehabilitation program during the inpatient stage of medical care. Results : Of the 81 children with cerebral palsy included in the study groups, 44 (54.3%) were boys and 37 (45.7%) were girls. The children's ages ranged from 1 year to 6.5 years. The children were divided into two groups: the study group and the comparison group. To assess effectiveness, the Ashforth Spasticity Scale, the Gross Motor Function Measure (GMFM-88), goniometry, coordination testing, the Harkavi Index, and the WeeFIM were used. The study group utilized modern rehabilitation methods in combination with traditional Chinese medicine (Gua Sha and reflexology), while the comparison group utilized modern rehabilitation methods alone. Results : To assess adaptation using the Harkavi Index, it was found that rehabilitation interventions did not negatively impact the adaptive capacity of children in either group. After completion of rehabilitation measures and six months after their completion, the study group showed a persistent improvement in GMFM-88 scores (p=0.001), decreased tone on the Ashworth scale (p=0.001), improved balance (p=0.003), and improved functional independence (p=0.001). No clear improvements were observed in the comparison group. Conclusion . Thus, incorporating Traditional Chinese Medicine methods into the rehabilitation program for children with cerebral palsy is advisable.
The paper provides a comparative analysis of modern medical triage systems for children affected by emergency situations. Four key systems are considered: JumpSTART (Simple triage and rapid treatment), Pediatric Triage Tape (PTT), Care Flight Triage and SALT. It was concluded that the Care Flight Triage system is the most preferable for use by ordinary medical professionals in stressful emergency situations. Its key advantages are the simplicity of the algorithm, high evaluation speed (about 15 seconds per child) and sufficient accuracy for these conditions. Other systems, such as JumpSTART (which has age restrictions), PTT (which requires special equipment) and SALT (Sort, Assess, Life-Saving Interventions, Treatment/Transport) (which has a complex structure), are considered less practical for quick use by untrained specialists. A crucial condition for improving the effectiveness of medical and diagnostic care for children with mechanical injuries in emergencies is the training of medical personnel in the section «trauma surgery» with the principles of medical triage, which is currently practically absent in the programs of medical universities, organizations and departments of postgraduate medical training.
Autism spectrum disorders are characterized by marked heterogeneity. Standard clinical classification does not reflect the metabolic characteristics of patients, which limits the possibilities of laboratory stratification and a pathogenetically focused approach to treatment. One of the key biochemical pathways potentially involved in the pathogenesis of idiopathic forms of autism spectrum disorders is the methionine cycle and one-carbon metabolism. The aim of the study. To evaluate methionine cycle parameters in children with non-syndromic and idiopathic forms of autism spectrum disorders and determine their clinical and diagnostic significance. Materials and methods. A cross-sectional comparative study was conducted involving 65 children with multifactorial autism spectrum disorders (divided by the severity of autism spectrum disorders into 3 subgroups according to DSM-5: ASD Level 1, ASD Level 2, ASD Level 3) aged 44–72 months and 30 apparently healthy children in the control group. Homocysteine (Hcy), S-adenosylmethionine (AdoMet), and S-adenosylhomocysteine (AdoHcy) were determined by liquid chromatography with tandem mass spectrometry. The AdoMet/AdoHcy ratio was calculated as an integral indicator of methylation potential. Statistical analysis included nonparametric methods. Results. All subgroups of patients showed statistically significant differences from the control group for all indicators of one-carbon metabolism (p<0.001). An increase in homocysteine levels, a decrease in AdoMet concentrations, an accumulation of AdoHcy, and a significant decrease in the AdoMet/AdoHcy ratio were observed. The most pronounced methylation potential disturbances were detected in patients with autism spectrum disorders (ASD Level 3) according to DSM-5. The AdoMet/AdoHcy ratio demonstrated the highest diagnostic specificity among clinical groups. Conclusion. A systemic methionine cycle imbalance was detected in children with multifactorial autism spectrum disorders. A comprehensive assessment of Hcy, AdoMet, and AdoHcy, as well as calculation of the AdoMet/AdoHcy ratio, can be considered a promising tool for the laboratory diagnosis of autism spectrum disorders in patients and for the justification of pathogenetically targeted metabolic interventions in pediatric practice.
Early microbial colonization influences the risk of congenital infections during the neonatal period. The aim. To assess the spectrum and frequency of primary microbial colonization in conditionally healthy term and late preterm newborns at risk for early-onset neonatal sepsis (EONS) immediately after birth, and to determine the clinical significance of the identified pathogens. Materials and Methods. A prospective single-center study (City Clinical Hospital No. 67, Moscow, September 2024 — March 2025) included 705 newborns (GA 35–42 weeks). Bacteriological samples were collected immediately after birth from two non-sterile sites — the nasopharynx and anus. A total of 1407 cultures were obtained. Microorganisms were identified using mass spectrometry. Results. Bacterial growth was detected in 14.4 % (nasopharynx) and 16.8 % (anus) of healthy full-term and late preterm newborns. Fifteen genera were identified; Gram-positive cocci predominated (22.3 %), while Gram-negative bacteria were less common (6.5 %). The dominant species were Streptococcus agalactiae, Escherichia coli, Staphylococcus epidermidis, and Enterococcus faecalis. Vaginal delivery was associated with a higher frequency of S. epidermidis colonization (6.8% vs 1.6%; p=0.006). Conclusion. Screening of cultures from non-sterile sites in apparently healthy newborns may serve as an accessible tool for early risk stratification of EONS.
Late prematurity (340/₇–366/₇ weeks) accounts for up to 75% of all cases of premature birth. Despite the fact that in clinical practice they are equated with full-term babies, they are at increased risk of respiratory, metabolic, infectious and neurological disorders. This necessitates a differentiated multidisciplinary approach to reduce adverse outcomes. The aim is to conduct a comparative analysis of the early neonatal period in children born at 340/₇-366/₇ weeks and full–term newborns.; to determine the relationship of pathological conditions in infants with risk factors identified in the mothers’ medical history. Materials and methods: The study group: 140 children born at late prematurity (340/₇–366/₇ weeks of gestation). The control group: 140 children born at full term (370/₇–416/₇ weeks of gestation). The analyzed parameters include weight and growth indicators, outcomes of the early neonatal period, the need for respiratory support and intensive care, as well as maternal anamnestic data. The data was processed using StatTech software, version 3.1.10. Results. Late premature newborns have a statistically significantly higher risk of developing pathological conditions in the early neonatal period compared with full-term peers (all comparisons p<0,001). Significant maternal risk factors were identified: body mass index > 23 kg/m2 and < 28 kg/m2 (increases the risk of late premature birth); maternal age ≥ 34 years (associated with the need for ventilation); age ≥ 32 years (risk of grade II cerebral ischemia); age 36 years (increased risk of intrauterine pneumonia). Conclusions. Late premature newborns have less perfect compensatory capabilities compared to full-term infants. The leading pathological conditions — respiratory disorders, hypoglycemia, hyperbilirubinemia and neurological dysfunctions — lead to a longer hospital stay and the need for high-tech care. Body mass index and maternal age are significant predictors of the risk of complications in a late pre-term newborn.
With the increasing number of military conflicts, acts of terrorism, and the use of modern weaponry, the problem of gunshot and mine-blast trauma (MBT) in children has acquired exceptional medical and social significance. Children constitute up to 20-50% of mass casualties victims, and the mortality rate for such injuries, according to various sources, reaches 57.1%. This review summarizes the keynote presentations of the symposium "Gunshot Wound," held as part of the XIII All-Russian Scientific and Practical Forum "Emergency Pediatric Surgery and Traumatology" (February 2025). Based on an analysis of the presented experience (including cases from Belgorod, Sevastopol, Moscow, and the Donetsk People's Republic), fundamental principles of providing care are identified. These include: a clear organization of staged medical evacuation based on effective triage of victims according to the «three streams» principle (red, yellow, green), and a presentation of the "golden hour" concept. A multidisciplinary approach, integrating the efforts of surgeons, traumatologists, ICU staff, psychologists, and rehabilitation specialists at all stages, is recognized as the cornerstone of the study. Particular attention is paid to combating wound infection, criticizing irrational antibiotic prevention and recommending the use of modern physical debridement methods, particularly low-temperature argon plasma, which demonstrates a pronounced antimicrobial effect and stimulates reparative processes. Early initiation of comprehensive physical and psychological rehabilitation to prevent contractures, chronic pain syndrome, and post-traumatic stress disorders is considered essential for a successful outcome. Thus, the problem requires a comprehensive multidisciplinary approach combining highly qualified surgical care with a well-established organizational system at all levels. The presented experience serves as the basis for the development of unified clinical guidelines aimed at increasing survival and improving the quality of life of children affected by military conflicts and emergency situations.
Recent studies have confirmed that increased intestinal permeability syndrome plays a key role in the pathogenesis of allergic diseases, while peripheral tight junction proteins like ZO-1 may serve as potential biomarkers for assessing gut barrier integrity. The aim of the study. To evaluate serum ZO-1 levels as a marker of epithelial barrier dysfunction in children with gut barrier impairment and food allergy. Materials and methods. The study included 27 children with cow’s milk protein allergy (CMPA, Group I) aged 1 month to 3 years and 20 healthy controls (Group II). Serum ZO-1 and fecal calprotectin (FC) were measured by ELIZA. Statistical analysis used MannWhitney U test, Spearman’s correlation, and ROC analysis. Results. Gastrointestinal symptom severity (GSS) was scored based n crying, regurgitation, stool, etc. Group I showed significantly higher GSS (Ме=13, Q1-Q3:7–18) versus controls (Ме=3, Q1-Q3:1–4,5). Serum ZO-1 levels were significantly lower in CMPA patients (Ме=0,007 ng/mL, Q1-Q3:0–0,031) compared to controls (Ме=0,033 ng/mL, Q1-Q3:0,027–0,135; p<0,05). FC levels also differed significantly: 286 μg/g (Group I) vs 87 μg/g (controls; p<0,001). Inverse correlations were found between ZO-1 and FC (r=-0,675; p<0,01) and between ZO-1 and GSS (r=-0,605; p<0.05). Conclusion. Decreased ZO-1 levels and elevated fecal calprotectin confirm intestinal barrier damage in CMPA patients. ZO-1 serves as a reliable marker of barrier integrity, while its combination with FC enhances diagnostic value for predicting allergy progression and atopic march risk.
Loeys-Dietz syndrome is a monogenic connective tissue disease with an autosomal dominant inheritance pattern. The TGFBR1, TGFBR2, TGFB2, TGFB3, SMAD2, and SMAD3 genes, which are associated with six types of the syndrome, encode components of the transforming growth factor β (TGFβ) signaling pathway. The pathogenesis of the syndrome is associated with impaired signal transmission in this signaling pathway, which leads to impaired structure and function of the connective tissue elements in many organs and systems, including the cardiovascular, respiratory, musculoskeletal, central nervous, and visual systems. The article presents an analysis of the medical histories of 7 children with types 1 and 2 of Loeys-Dietz syndrome, which was confirmed by molecular genetics (mutations in the TGFBR1 and TGFBR2 genes). All 7 probands had cardiovascular and musculoskeletal disorders, as well as allergic manifestations. It was noted that all patients had abnormalities in their urinary system. The clinical data of a child who inherited the disease from an ill mother are provided in detail. A differential diagnosis was performed with other phenotypically similar monogenic connective tissue diseases. It is emphasized that medical supervision of patients with Loeys-Dietz syndrome should be carried out with the participation of a clinical geneticist, cardiac and orthopedic surgeons, a nephrologist, an allergist, and an ophthalmologist. The insufficient effectiveness of medical and cardiac surgical methods highlights the importance of developing a pathogenetic therapy for this severe disease.
Updated information about local antimicrobial susceptibility data is extremely important in prescription of empiric antibacterial therapy. Aim : dynamic monitoring of local data on the etiological structure of pathogens causing urinary tract infections in children and the level of antibacterial drugs resistance of isolated microorganisms. Materials and methods : this retrospective study evaluated urine analysis from 550 female and male patients aged 1 month to 18 years with urinary tract infections at the I.N. Grigovich Children’s Republican Hospital in Petrozavodsk, during 2018, 2022, 2023 years. The results of the study . The study analyzed 301 isolates in 2018, 207 in 2022, 42 in 2023. Enterobacteria were isolated most frequently – 43–71%, of which Escherichia coli – 69–78%, Klebsiella – 14–19%. Escherichia coli resistance to ampicillin has almost doubled by 2022 - from 57% to 88%, p=0.028, in 2023 - 40%. Аmoxicillin/clavulanate - a high level of resistance remains - 2018 and 2022 - 16% and 55%, 2023 - 10% (95% CI, ±11.142). The level of resistance to third- and fourth-generation cephalosporins has almost doubled over 5 years: cefepime from 23% to 42%, in 2023 - 10% (95% CI, ±11.142), cefotaxime from 24% to 39%, in 2023 - 13% (95% CI, ±12.612). The lowest level of resistance throughout all years to meropenem, nitrofurantoin, fosfomycin, amikacin, gentamicin. Conclusion . The primary local uropathogen is Escherichia coli . Local administration of ampicillin is not permissible in treatment of pediatric urinary tract infections, the use of III-IV generations cephalosporins should be restricted.
Congenital liver cysts are a rare pathology, however, due to the modern availability of visual diagnostic methods, primarily ultrasound, cases of their detection have become more frequent. Children in whom a cystic liver formation was detected during antenatal ultrasound screening should be observed dynamically after birth with laboratory and instrumental examination methods, and the issue of the timing of surgical intervention should be decided. Differential diagnostics of congenital liver cysts with other cystic lesions of the abdominal organs can be difficult even when several visual examination methods are used. In our clinical observations, based on the data of instrumental studies, the diagnosis of a congenital choledochal cyst seemed most likely, however, an isolated liver cyst with its morphological verification was diagnosed intraoperatively. Conclusions . Congenital liver cysts are a rare pathology, which is now increasingly detected antenatally, which allows for timely excision of the cyst, preventing possible complications and malignancy.
The main focus of neurorehabilitation is the prevention and correction of functional impairments in a child's organs or systems following neuroinfectious diseases. The aim of the study . To scientifically substantiate the application of a comprehensive rehabilitation program based on reflexotherapy for children with sequelae of meningitis and encephalitis during the inpatient stage. Materials and Methods. The study involved 63 children aged 1 to 14 years with viral or bacterial meningitis or viral encephalitis, including 29 girls (46.0%) and 34 boys (54.0%). The control group received standardized rehabilitation, while the main group additionally received reflexotherapy. Results . Outcomes in both groups were assessed before and after rehabilitation, and at 3 and 6 months using the following measures: the Gross Motor Function Measure (GMFM-88) – recovery of motor functions in the main group significantly exceeded that in the control group (at 6 months: χ2-Pearson=42.995, p=0.001); the Modified Ashworth Scale – improvement in the main group was statistically significantly greater than in the control group for the upper extremities (χ2-Pearson=10.233, p=0.017). Also, according to the results received from the Visual Analogue Scale during the investigation: in the main group, after 6 months, there was a significant decrease in the number of children complaining of headaches - when compared with the indicators in the comparison group, the result was statistically sig- nificant (χ2-Pearson=8.627, p=0.003). Conclusion . Reflexotherapeutic approaches contribute to improved coordination, increased range of motion in joints, reduced muscle tone, decreased levels of asthenia and headache intensity, as well as enhanced motor functions in children after meningitis or encephalitis. Incorporating reflexotherapy into the rehabilitation program increases the effectiveness of rehabilitation measures and improves the child's quality of life.
According to the classification of the International Society for the Study of Vascular Anomalies (ISSVA), vascular anom- alies include a wide range of pathologies classified as vascular tumors or vascular malformations. This classification, last updated in 2018, is intended to explain the biological basis of vascular anomalies and help doctors in their treatment. In vascular tumors, proliferative changes in endothelial cells are observed, while vascular malformations are mainly struc- tural vascular anomalies. Vascular malformations are an extensive group of malformations of the arterial, venous, and lymphatic systems, both isolated and in combination with each other. Radiological examination plays a key role in the treatment of children with these diseases. This clinical example describes the stages of diagnosis and treatment of a child with arteriovenous malformation of the soft tissues of the back of the neck.
