Vein of Galen Malformation

Cordova, Erika G.; Levy, Philip; Kheir, John N.; Orbach, Darren B.; Estroff, Judy A.

doi:10.1542/neo.21-10-e678

Cited by 7 publications

(2 citation statements)

References 28 publications

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“…weeks (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Postnatal outcome are depicted in Table 2.…”

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confidence: 99%

A systematic review of prenatal diagnosis Vein of Galen aneurysm: prenatal predictive markers and management from the fetal life to childhood

Meglio,

Sica,

Toscano

et al. 2023

Preprint

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Background Vein of Galen malformations (VGMs)account for less than 1% of all intracranial vascular malformations. However in the fetal and pediatric population represent the most common vascular malformation of the brain. An optimal knowledge of the prenatal and postnatal clinical features is mandatory for an effective management. Methods Articles published between 1st January 2003 and 1st January 2023, reported in PUBMED and EMBASE, were evaluated for a systematic review analyzing prenatal features, postnatal features and management of fetal Galean VGMs. Results Twenty-nine papers reporting information on 50 prenatally-diagnosed VGM were included. The most common prenatal features were: fetal hydrocephalus (40%) and cardiomegaly (58%). Post-natal data of 42 VGMs cases are described .The overall mortality was 59,52%. 76,50% of the survivors had a normal development. Conclusions A close follow-up and a multidisciplinary approach is mandatory to manage this condition. The aim of our study was to provide a guide to gynecologist, neonatologist, cardiologist, and neuroradiologist.

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“…weeks (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Postnatal outcome are depicted in Table 2.…”

mentioning

confidence: 99%

A systematic review of prenatal diagnosis Vein of Galen aneurysm: prenatal predictive markers and management from the fetal life to childhood

Meglio,

Sica,

Toscano

et al. 2023

Preprint

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“…2 These conditions are increasingly identified prenatally and are referred to subspecialized centers for counseling and treatment planning. 3 VOGMs and NG-AVFs result in direct communication between the arterial and vascular beds, creating high-flow intracranial shunts and secondary high-cardiac-output states. Even though the hemodynamic repercussions of a high-output state do manifest prenatally, end-organ injury is rare.…”

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confidence: 99%

Brain Injury in Fetuses with Vein of Galen Malformation and Nongalenic Arteriovenous Fistulas: Static Snapshot or a Portent of More?

Jaimes¹,

Machado‐Rivas²,

Chen³

et al. 2022

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Brain injury in fetuses with vein of Galen malformations and nongalenic AVFs is a rare complication whose appearance, course, and prognosis are poorly studied. We sought to characterize the MR imaging features and examine associations with postnatal outcome. MATERIALS AND METHODS:This was a retrospective analysis of fetal MRIs of subjects with vein of Galen malformation and nongalenic arteriovenous fistulas. Two pediatric neuroradiologists independently reviewed examinations to determine the presence of abnormalities on structural imaging (T1 volumetric interpolated breath-hold examination and T2-HASTE), DWI, and T2*-weighted images; discrepancies were adjudicated by a third reviewer. Radiologic progression of injury was determined by additional fetal or neonatal MRIs. A simple composite score evaluating poor neonatal clinical outcome as either intubation or death by postnatal day 2 was also queried. A body fetal imager evaluated the presence of systemic findings of right heart strain.RESULTS: Forty-nine fetal MR imaging examinations corresponding to 31 subjects (27 vein of Galen malformations and 4 nongalenic AVF cases) were analyzed. Injury was observed in 8 subjects (26%) with 14 fetal examinations; the mean gestational age at identification of injury was 32.2 (SD 4.9) weeks. Structural abnormalities were present in all subjects with injury; restricted diffusion, in 5/7 subjects with available data; and T2* abnormalities, in all subjects with available data (n ¼ 7). Radiologic progression was documented in all cases with follow-up imaging (n ¼ 7). All subjects with fetal brain injury had a poor neonatal clinical outcome. CONCLUSIONS:Brain injury in fetuses with vein of Galen malformation and nongalenic AVFs shows a combination of structural abnormalities, restricted diffusion, and blooming on T2* images. Injury appears to portend a poor prognosis, with relentless progression and a likely association with adverse neonatal outcomes.

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