Vein of Galen malformations in the newborn: case series.
Lasjaunias
Yaşargil
classification
embolization
vein of Galen malformation
Journal
Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676
Informations de publication
Date de publication:
12 Jun 2023
12 Jun 2023
Historique:
received:
11
04
2023
accepted:
28
04
2023
medline:
19
6
2023
pubmed:
19
6
2023
entrez:
19
6
2023
Statut:
epublish
Résumé
Vein of Galen malformations (VoGMs) in newborns often represent life-threatening emergencies. Outcome is difficult to predict. The authors review 50 VoGM cases to correlate anatomical types with treatment and outcome. Four distinct types of VoGMs are identified: mural simple (type I), mural complex (type II), choroidal (type III), and choroidal with deep venous drainage (type IV). Seven patients presented with mural simple VoGMs with a "single hole" fistula supplied by only one large feeder. These patients were treated electively at >6 months; development was normal. Fifteen patients presented with complex mural VoGMs. Multiple large feeders joined a single fistulous point within the wall of the varix. Patients typically presented with congestive heart failure (CHF) and required emergent transarterial intervention. Mortality was 7.7% with less than two-thirds developing normally. Twenty-five patients presented with choroidal VoGMs. Multiple large arterial feeders joined at multiple fistulous sites. Severe CHF in most patients required emergent transarterial and sometimes transvenous intervention. Mortality was 9.5%; two-thirds of the patients had a normal development. Three babies presented with choroidal VoGMs with deep intraventricular venous drainage. This phenomenon caused fatal "melting brain syndrome" in all three patients. Recognition of the specific VoGM type determines treatment options and sets outcome expectations.
Sections du résumé
BACKGROUND
BACKGROUND
Vein of Galen malformations (VoGMs) in newborns often represent life-threatening emergencies. Outcome is difficult to predict. The authors review 50 VoGM cases to correlate anatomical types with treatment and outcome.
OBSERVATIONS
METHODS
Four distinct types of VoGMs are identified: mural simple (type I), mural complex (type II), choroidal (type III), and choroidal with deep venous drainage (type IV). Seven patients presented with mural simple VoGMs with a "single hole" fistula supplied by only one large feeder. These patients were treated electively at >6 months; development was normal. Fifteen patients presented with complex mural VoGMs. Multiple large feeders joined a single fistulous point within the wall of the varix. Patients typically presented with congestive heart failure (CHF) and required emergent transarterial intervention. Mortality was 7.7% with less than two-thirds developing normally. Twenty-five patients presented with choroidal VoGMs. Multiple large arterial feeders joined at multiple fistulous sites. Severe CHF in most patients required emergent transarterial and sometimes transvenous intervention. Mortality was 9.5%; two-thirds of the patients had a normal development. Three babies presented with choroidal VoGMs with deep intraventricular venous drainage. This phenomenon caused fatal "melting brain syndrome" in all three patients.
LESSONS
CONCLUSIONS
Recognition of the specific VoGM type determines treatment options and sets outcome expectations.
Identifiants
pubmed: 37334971
doi: 10.3171/CASE23201
pii: CASE23201
pmc: PMC10550657
doi:
pii:
Types de publication
Journal Article
Langues
eng
Références
Oper Neurosurg (Hagerstown). 2019 Sep 1;17(3):286-292
pubmed: 31111161
Childs Nerv Syst. 2015 Jul;31(7):1033-5
pubmed: 25985841
Pediatr Neurosurg. 2021;56(6):584-590
pubmed: 34614493
World Neurosurg. 2018 Aug;116:296-298
pubmed: 29864556
Interv Neuroradiol. 2017 Feb;23(1):97-101
pubmed: 27837112
Am J Perinatol. 2019 Jan;36(2):169-175
pubmed: 29991070
J Neurosurg. 1960 Nov;17:945-54
pubmed: 13762765
Pediatr Cardiol. 2023 Jan;44(1):254-259
pubmed: 36418550
World J Clin Cases. 2019 Apr 6;7(7):855-862
pubmed: 31024957
Ann Pediatr Cardiol. 2018 Sep-Dec;11(3):304-307
pubmed: 30271022
Cureus. 2021 Dec 1;13(12):e20067
pubmed: 34987934
J Cardiothorac Surg. 2018 Jun 13;13(1):66
pubmed: 29895303
World Neurosurg. 2020 Jun;138:35-38
pubmed: 32113993
Pediatr Neurosurg. 2021;56(4):401-406
pubmed: 34107474
Childs Nerv Syst. 2016 Apr;32(4):709-15
pubmed: 26499346
World J Clin Pediatr. 2017 Feb 8;6(1):103-109
pubmed: 28224101
Neuroradiology. 1989;31(2):109-28
pubmed: 2664553
Interv Neuroradiol. 2023 Apr;29(2):183-188
pubmed: 35234073
J Child Neurol. 2008 Apr;23(4):441-6
pubmed: 18230846
World Neurosurg. 2016 Jul;91:672.e11-5
pubmed: 27102351
J Neurosurg Pediatr. 2017 Jun;19(6):729-733
pubmed: 28338447
Interv Neuroradiol. 2021 Oct;27(5):663-666
pubmed: 33611967
Turk Neurosurg. 2021;31(4):661-664
pubmed: 33978207
Childs Nerv Syst. 2015 Jan;31(1):135-40
pubmed: 25358810
Maedica (Bucur). 2016 Dec;11(4):334-340
pubmed: 28828053
Neurochirurgie. 2022 Oct;68(5):540-543
pubmed: 35039164
J Neurosurg Pediatr. 2016 Aug;18(2):231-4
pubmed: 27058455
BMJ Open. 2022 May 24;12(5):e058147
pubmed: 35613814
J Neurosurg Pediatr. 2013 Sep;12(3):293-306
pubmed: 23889354
BMJ Case Rep. 2019 Apr 14;12(4):
pubmed: 30988102
Childs Nerv Syst. 2021 Oct;37(10):3271-3276
pubmed: 33595709
J Neurosurg Pediatr. 2018 Oct 5;23(1):86-91
pubmed: 30485233
Radiol Case Rep. 2022 Dec 22;18(3):886-894
pubmed: 36589489
Neurosurgery. 2006 Nov;59(5 Suppl 3):S184-94; discussion S3-13
pubmed: 17053602
Neurosurgery. 2012 May;70(5):1207-13; discussion 1213-4
pubmed: 22089754
Surg Neurol. 1976 Sep;(3):195-200
pubmed: 959995
J Neurosurg Case Lessons. 2022 Oct 10;4(15):
pubmed: 36461836
J Neurosurg Pediatr. 2018 Apr;21(4):380-383
pubmed: 29372854
BMJ Case Rep. 2019 Sep 4;12(9):
pubmed: 31488452
J Neurol Neurosurg Psychiatry. 2003 Mar;74 Suppl 1:i42-4
pubmed: 12611934
N Engl J Med. 2020 Oct 8;383(15):e90
pubmed: 33027572
Pediatr Neurosurg. 2017;52(2):136-139
pubmed: 28092907
Fetal Diagn Ther. 2003 Nov-Dec;18(6):408-11
pubmed: 14564110