[Vein of Galen arteriovenous malformations and neonatal convulsions].
BACKGROUND
Vein of Galen arteriovenous malformation (VGAM) appears during the embryonic period and gives rise to a complex network of arterial and venous vessels that generates a blood shift, from the brain parenchyma towards the malformation, with haemodynamic repercussions. Heart failure is the most frequent presenting symptom during the neonatal period, yet, convulsions or other neurological signs have occasionally been reported in this stage of life.


METHODS
A term infant with symptoms of heart failure and convulsions that began during the first 12 hours of life. CAT and magnetic resonance angiography scans revealed a vascular malformation and areas of cerebral ischaemia.


CONCLUSIONS
In the case of our patient, detecting areas of ischaemia in the cerebral hemispheres suggested that the damage could be caused by a "steal" syndrome leading the blood flow away from these areas towards the malformation. This situation can occur either before or after birth and the self-limiting nature of the seizures in cerebral infarcts could lead to them going noticed because they take place inside the uterus or when the patient is not being observed directly by his or her health care providers. We suspect that the convulsions in newborn infants with this malformation may well be more frequent than is currently believed.
Trujillo
C
C
Servicio de Neonatología, Hospital Universitario Materno Infantil, E-35011 Las Palmas de Gran Canaria, Spain. ctcem@hotmail.com
González-Luis
G
G
Avila-Suárez
R
R
Santana-Reyes
C
C
González-González
R
R
García-Muñoz
F
F
D001919:Bradycardia / Q000209:etiology; D002545:Brain Ischemia / Q000209:etiology; D006332:Cardiomegaly / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000209:etiology; D002550:Cerebral Veins / Q000002:abnormalities*; D002560:Cerebrovascular Circulation; D004621:Embolization, Therapeutic; D005260:Female; D005315:Fetal Diseases / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000628:therapy; D000860:Hypoxia / Q000209:etiology; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D011596:Psychomotor Disorders / Q000209:etiology; D013036:Spasms, Infantile / Q000209:etiology*; D013353:Subdural Effusion / Q000209:etiology; D014463:Ultrasonography; D017287:Ventriculoperitoneal Shunt