title: Definitive treatment of vein of Galen aneurysmal malformation with stereotactic radiosurgery.
abstract: Vein of Galen aneurysmal malformations (VGAMs) are uncommon congenital malformations arising from fistulous communication with the median vein of the prosencephalon, a primitive precursor of midline cerebral venous structures. Angiographic embolization is the primary modality for treatment given historically poor microsurgical outcomes. Only a few reports of treatment by Gamma Knife radiosurgery (GKRS) exist in the literature, and the results are variable. The authors present 2 cases of VGAM in which GKRS provided definitive treatment with good outcome: one case involving antenatal presentation of a high-output, mural-type VGAM with complex clinical course refractory to multiple embolic procedures, and the other a choroidal-type VGAM presenting with hemorrhage in an adult and without a feasible embolic approach. With discussion of these cases and review of the literature, the authors advocate inclusion of GKRS as a therapeutic option for treatment of these complex lesions.
authors.affiliation: Departments of Radiology.
authors.forename: William J
authors.initials: WJ
authors.lastname: Triffo
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Bourland
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Couture
authors.forename: Kevin P
authors.initials: KP
authors.lastname: McMullen
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Tatter
authors.forename: Padraig P
authors.initials: PP
authors.lastname: Morris
mesh_terms: D000328:Adult; D002550:Cerebral Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D002675:Child, Preschool; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D011859:Radiography; D016634:Radiosurgery / Q000295:instrumentation*; D016896:Treatment Outcome; D054080:Vein of Galen Malformations / Q000000981:diagnostic imaging / Q000601:surgery*