Vein of Galen vascular malformations in infants: clinical, radiological and therapeutic aspect

Borthne, Arne; Carteret, Michel; Baraton, J.; Courtel, Jean-Vincent; Brunelle, Françis

doi:10.1007/s003300050285

Cited by 36 publications

(17 citation statements)

References 18 publications

(42 reference statements)

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“…The literature search identified a total of 34 studies, [3][4][5][6][7][8][9][12][13][14][15]17,20,[22][23][24][25]28,30,[32][33][34][35][36][37][38][39][40][41][42]45,46,50,51 which included 667 patients whose VGAMs were treated by endovascular embolization (Fig. 1).…”

Section: Identification Of Eligible Studiesmentioning

confidence: 99%

Outcome and complications of endovascular embolization for vein of Galen malformations: a systematic review and meta-analysis

Yan¹,

Wen

Gopaul³

et al. 2015

JNS

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V ein of Galen aneurysmal malformations (VGAMs) are cerebral arteriovenous malformations of the choroidal system draining into the vein of Galen forerunner. Although they represent approximately 1% of all intracranial vascular lesions, they account for 30% of vascular malformations in the pediatric age group.7 Endovascular embolization is the first option for VGAMs. 15,20,30,36 obJect There have been many multidisciplinary approaches to the treatment of vein of Galen malformations. Endovascular embolization is the first option for treatment. However, the effects of the treatment remain controversial. The aim of this study is to assess the efficacy and safety of endovascular embolization to treat patients with vein of Galen malformations. methods This paper includes a retrospective analysis of a sample of 667 patients who underwent endovascular embolization to treat vein of Galen malformations. The data were obtained through a literature search of PubMed databases. The authors also evaluate the efficacy and safety of the treatment. Mortality within the follow-up period is analyzed. Pooled estimates of proportions with corresponding 95% CIs were calculated using raw (i.e., untransformed) proportions (PRAW). results In the 34 studies evaluated, neonates accounted for 44% of the sample (95% CI 31%-57%; I 2 = 92.5%), infants accounted for 41% (95% CI 30%-51%; I 2 = 83.3%), and children and adults accounted for 12% (95% CI 7%-16%; I 2 = 52.9%). The meta-analysis revealed that complete occlusion was performed in 57% (95% CI 48%-65%; I 2 = 68.2%) of cases, with partial occlusion in 43% (95% CI 34%-51%; I 2 = 70.7%). The pooled proportion of patients showing a good outcome was 68% (95% CI 61%-76%; I 2 = 77.8%), while 31% showed a poor outcome (95% CI 24%-38%; I 2 = 75.6%). The proportional meta-analysis showed that postembolization mortality and complications were reported in 10% (95% CI 8%-12%; I 2 = 42.8%) and 37% (95% CI 29%-45%; I 2 = 79.1%), respectively. Complications included cerebral hemorrhage, cerebral ischemia, hydrocephalus, leg ischemia, and vessel perforation. coNclusioNs The successful treatment of vein of Galen malformations remains a complex therapeutic challenge. The authors' analysis of clinical history and research literature suggests that vein of Galen malformations treated with endovascular embolization can result in an acceptable mortality rate, complications, and good clinical outcome. Future large-scale, multicenter, randomized trials are necessary to confirm these findings.

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Section: Identification Of Eligible Studiesmentioning

confidence: 99%

Outcome and complications of endovascular embolization for vein of Galen malformations: a systematic review and meta-analysis

Yan¹,

Wen

Gopaul³

et al. 2015

JNS

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“…According to previous reports, the ratio of VGAM patients who underwent emergency endovascular surgery during the neonatal stage and achieved normal development ranged from 0 to 50% [1, 2, 3, 5, 6, 8, 14, 15, 16]. We have presented a patient who underwent a successful endovascular procedure as a neonate, and who is now 5 years old without neurological deficits or developmental retardation.…”

Section: Discussionmentioning

confidence: 99%

“…Although recent advances in endovascular therapeutic techniques have improved the prognosis of patients with vein of Galen malformation (VGAM), the outcomes of neonates with severe heart failure still remain unsatisfactory [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12]. Moreover, there are few long-term follow-up studies reporting on the functional development of these patients [5].…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of a Neonate with Vein of Galen Aneurysmal Malformation

et al. 2000

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We present a follow-up study on a 5-year-old boy who was born with vein of Galen aneurysmal malformation (VGAM) accompanied by extreme cardiovascular distress. He was successfully treated by the staged endovascular technique during the neonatal stage. Postoperative angiographic study confirmed complete occlusion of the VGAM and the establishment of normal brain perfusion. At 5 years of age, the child is growing normally without neurological deficits or developmental retardation. We suggest that the restoration of normal brain perfusion in neonates with VGAM can cause normal brain development.

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“…This vascular malformation often remains unidentified during the prenatal period but with the improvement in obstetric ultrasound scanning and especially MRI techniques, more prenatal cases will be diagnosed 3. MRI is crucial because most of the prenatal cases diagnosed and reported in the literature, involve cardiac abnormalities which recurrently reflect an aggressive lesion that brings about neonatal cerebral ischemia and encephalomalacia 4. In the Necker children's hospital experience, prenatal diagnosis was made in one out of fourteen patients 5. This is mandatory in order to evaluate the severity of the shunt and the damage that the brain incurred 2 .…”

Section: Discussionmentioning

confidence: 99%

Correlation of Prenatal MRI and Autopsy Findings in the Diagnosis of Vein of Galen Arteriovenous Malformation

Berge

Maugey²,

Charles

et al. 2001

Interv Neuroradiol

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We report the case of an arteriovenous malformation (AVM) of the vein of Galen diagnosed in utero at the 34th week of gestation by ultrasound and MRI. Following interdisciplinary advice, the family decided to terminate the pregnancy. This was carried out in the 36th week of gestation. Mascroscopic study of the fetus confirmed the in utero diagnosis: considerable dilatation of the cerebral arteries, the Galen vein and the anteroinferior sinuses. Based on the correlation of pre and post natal examinations, this study highlights the accuracy of in utero MRI, coupled with ultrasound scanning in the diagnosis of an AVM of the Galen vein. It provides specific information on the degree of cerebral impairment. MRI in utero helps in decision-making for pregnancy termination.

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Vein of Galen vascular malformations in infants: clinical, radiological and therapeutic aspect

Cited by 36 publications

References 18 publications

Outcome and complications of endovascular embolization for vein of Galen malformations: a systematic review and meta-analysis

Outcome and complications of endovascular embolization for vein of Galen malformations: a systematic review and meta-analysis

Successful Treatment of a Neonate with Vein of Galen Aneurysmal Malformation

Correlation of Prenatal MRI and Autopsy Findings in the Diagnosis of Vein of Galen Arteriovenous Malformation

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