Vein of Galen vascular malformations in infants: clinical, radiological and therapeutic aspect.
A series of 14 vein of Galen vascular malformations diagnosed in the pediatric populations and treated at the Hospital for Sick Children-Necker, Paris, between 1988 and 1994 is presented. Five of the patients were diagnosed in the neonatal period, of whom 4 presented with life-threatening, intractable cardiac decompensation and high-flow arteriovenous fistulae. Embolization was performed on vital indications in 4 patients during the first week after birth. One embolization failed with fatal outcome. Of the 3 who were embolized, 2 succumbed within 1 week and 1 survived with marked improvement of cardiac symptoms. The older children presented with hydrocephalus and neurologic symptoms. The 10 patients older than 1 year were embolized. These procedures were successful in 90 %, with hemodynamic stabilization and improvement of clinical symptoms. In this group the mortality rate was 10 %. The total mortality rate was 29 %. Hydrocephalus was secondary to a compression of the Sylvian aqueduct in 44 % of cases. Five patients had ventricular drainage before embolization followed by a staged elective embolization. Transarterial embolizations were performed in 11 patients, whereas 2 patients were embolized via the transvenous route.
Borthne
A
A
Department of Pediatric Radiology, University Paris V, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, F-75 743 Paris Cedex 15, France.
Carteret
M
M
Baraton
J
J
Courtel
J
J
Brunelle
F
F
D001164:Arteriovenous Fistula / Q000151:congenital* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D002550:Cerebral Veins / Q000002:abnormalities*; D002675:Child, Preschool; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008297:Male