title: Normal perfusion pressure breakthrough complicating surgery for the vein of Galen malformation: report of three cases.
abstract: Three cases are described of infants who developed malignant brain swelling (and in one case hemorrhage) after surgery for vein of Galen malformations. The cause for the brain swelling was felt to be due to hyperperfusion, or the "normal perfusion pressure breakthrough" syndrome. Although well-described for cerebral parenchymal arteriovenous malformations, cases of this complication occurring in vein of Galen malformations have not previously been reported. It is concluded from these cases that infants with large arteriovenous shunts, as attested by cardiac failure and cerebral atrophy, have an increased risk of developing this complication.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: M K
authors.initials: MK
authors.lastname: Morgan
authors.forename: I H
authors.initials: IH
authors.lastname: Johnston
authors.forename: T M
authors.initials: TM
authors.lastname: Sundt
mesh_terms: D001929:Brain Edema / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000473:pathology; D002550:Cerebral Veins / Q000002:abnormalities*; D003399:Craniotomy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D007427:Intracranial Pressure; D007431:Intraoperative Complications / Q000473:pathology*; D008297:Male; D011183:Postoperative Complications / Q000473:pathology*; D012086:Reoperation; D015427:Reperfusion Injury / Q000473:pathology*