Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Child's Nervous System
Published in: Child's Nervous System 10/2010

01-10-2010 | Special Annual Issue

Endovascular management of vein of Galen aneurysmal malformations. Influence of the normal venous drainage on the choice of a treatment strategy

Authors: Monica Pearl, Juan Gomez, Lydia Gregg, Philippe Gailloud

Published in: Child's Nervous System | Issue 10/2010

Login to get access

Abstract

Introduction

Vein of Galen arteriovenous malformations (VGAM) are rare intracranial vascular lesions mostly involving young children. Endovascular therapy is the current standard of care. Albeit interventional techniques have greatly reduced the once dismal vital and functional prognoses previously associated with these lesions, the treatment of VGAMs remains a complex therapeutic challenge.

Discussions

This article reviews the available endovascular options for VGAM therapy, emphasizing three points that we have identified as critical in our practice for the establishment of a treatment strategy: (1) the importance of the deep cerebral venous anatomy, in particular the existence of normal drainage through the Galenic system in spite of the VGAM; (2) the concept of treatment staging, for arterial as well as for venous interventions; and (3) the definition of a therapeutic goal that can be attained at a reasonable cost in terms of complication risks and functional outcome.
Literature
1.
Alvarez H, Garcia Monaco R, Rodesch G, Sachet M, Krings T, Lasjaunias P (2007) Vein of Galen aneurysmal malformations. Neuroimaging Clin N Am 17:189–206CrossRefPubMed
2.
Burger IM, Murphy KJ, Jordan LC, Tamargo RJ, Gailloud P (2006) Safety of cerebral digital subtraction angiography in children: complication rate analysis in 241 consecutive diagnostic angiograms. Stroke 37:2535–2539CrossRefPubMed
3.
Campi A, Rodesch G, Scotti G, Lasjaunias P (1998) Aneurysmal malformation of the vein of Galen in three patients: clinical and radiological follow-up. Neuroradiology 40:816–821CrossRefPubMed
4.
Casasco A, Lylyk P, Hodes JE, Kohan G, Aymard A, Merland JJ (1991) Percutaneous transvenous catheterization and embolization of vein of Galen aneurysms. Neurosurgery 28:260–266CrossRefPubMed
5.
Dowd CF, Halbach VV, Barnwell SL, Higashida RT, Edwards MS, Hieshima GB (1990) Transfemoral venous embolization of vein of Galen malformations. AJNR Am J Neuroradiol 11:643–648PubMed
6.
Emmanouilides GC, Hoy RC (1967) Transumbilical aortography and selective arteriography in newborn infants. Pediatrics 39:337–343PubMed
7.
Feletti A, Denaro L, Marton E, d’Avella D, Longatti P (2007) Endoscopic treatment of hydrocephalus due to aneurysm of the vein of Galen: case report and literature review. Minim Invasive Neurosurg 50:285–291CrossRefPubMed
8.
Gailloud P, O’Riordan DP, Burger I, Levrier O, Jallo G, Tamargo RJ, Murphy KJ, Lehmann CU (2005) Diagnosis and management of vein of Galen aneurysmal malformations. J Perinatol 25:542–551CrossRefPubMed
9.
Gailloud P, O’Riordan DP, Burger I, Lehmann CU (2006) Confirmation of communication between deep venous drainage and the vein of Galen after treatment of a vein of Galen aneurysmal malformation in an infant presenting with severe pulmonary hypertension. AJNR 27:317–320PubMed
10.
Gold AP, Ransohoff J, Carter S (1964) Vein of Galen malformation. Acta Neurol Scand 40(suppl 11):1–31
11.
Govaert P, Defoort P, Wigglesworth JS (1993) Cranial haemorrhage in the term newborn infant. Mac Keith, London, Distributed by Cambridge University of Press
12.
13.
Houdart E, Gobin YP, Casasco A, Aymard A, Herbreteau D, Merland JJ (1993) A proposed angiographic classification of intracranial arteriovenous fistulae and malformations. Neuroradiology 35:381–385CrossRefPubMed
14.
Iizuka Y, Kakihara T, Suzuki M, Komura S, Azusawa H (2008) Endovascular remodeling technique for vein of Galen aneurysmal malformations—angiographic confirmation of a connection between the median prosencephalic vein and the deep venous system. J Neurosurg Pediatr 1:75–78CrossRefPubMed
15.
Jaeger JR, Forbes RP, Dandy WE (1937) Bilateral congenital cerebral arteriovenous communication aneurysm. Trans Am Neurol Assoc 63:173–176
16.
Lasjaunias P, Terbrugge K, Piske R, Lopez Ibor L, Manelfe C (1987) Dilatation of the vein of Galen. Anatomoclinical forms and endovascular treatment apropos of 14 cases explored and/or treated between 1983 and 1986. Neurochirurgie 33:315–333PubMed
17.
Lasjaunias P, Garcia-Monaco R, Rodesch G, Ter Brugge K, Zerah M, Tardieu M, de Victor D (1991) Vein of Galen malformation. Endovascular management of 43 cases. Childs Nerv Syst 7:360–367CrossRefPubMed
18.
Lasjaunias P, Garcia-Monaco R, Rodesch G, Terbrugge K (1991) Deep venous drainage in great cerebral vein (vein of Galen) absence and malformations. Neuroradiology 33:234–238CrossRefPubMed
19.
Lasjaunias P (1997) Vein of Galen aneurysmal malformation. Vascular diseases in neonates, infants and children. Springer Verlag, Berlin-Heidelberg, pp 67–202
20.
Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R (2006) The management of vein of Galen aneurysmal malformations. Neurosurgery 59:S184–194, discussion S183-113CrossRefPubMed
21.
Levrier O, Gailloud PH, Souei M, Manera L, Brunel H, Raybaud C (2004) Normal Galenic drainage of the deep cerebral venous system in two cases of vein of Galen aneurysmal malformation. Childs Nerv Syst 20:91–97, discussion 98–99CrossRefPubMed
22.
Long DM, Seljeskog EL, Chou SN, French LA (1974) Giant arteriovenous malformations of infancy and childhood. J Neurosurg 40:304–312CrossRefPubMed
23.
Meyers PM, Halbach VV, Phatouros CP, Dowd CF, Malek AM, Lempert TE, Lefler JE, Higashida RT (2000) Hemorrhagic complications in vein of Galen malformations. Ann Neurol 47:748–755CrossRefPubMed
24.
Mickle JP, Quisling RG (1986) The transtorcular embolization of vein of Galen aneurysms. J Neurosurg 64:731–735CrossRefPubMed
25.
Moffat DB (1961) The development of the posterior cerebral artery. J Anat 95:485–494PubMed
26.
Pool JL, Potts DG (1965) Vein of Galen malformations. In: Pool JL, Potts DG (eds) Aneurysms and arteriovenous anomalies of the brain. Harper & Row, New York, pp 374–390
27.
Raybaud CA, Strother CM (1986) Persisting abnormal embryonic vessels in intracranial arteriovenous malformations. Acta Radiol Suppl 369:136–138PubMed
28.
Raybaud CA, Strother CM, Hald JK (1989) Aneurysms of the vein of Galen: embryonic considerations and anatomical features relating to the pathogenesis of the malformation. Neuroradiology 31:109–128CrossRefPubMed
29.
Spetzler RF, Wilson CB, Weinstein P, Mehdorn M, Townsend J, Telles D (1978) Normal perfusion pressure breakthrough theory. Clin Neurosurg 25:651–672PubMed
30.
Steinheil SO (1895) Ueber einen Fall von Varix aneurysmaticus im Bereich der Gehirngefaesse. F. Fromme, Wurzburg, p 56
31.
Wolfram-Gabel R, Maillot C, Koritke JG (1987) The vascular pattern in the tela choroidea of the prosencephalon in man. J Neuroradiol 14:10–26PubMed
32.
Yasargil MG (1984) Microneurosurgery. Georg Thieme—Thieme Stratton, Stuttgart
Metadata
Title
Endovascular management of vein of Galen aneurysmal malformations. Influence of the normal venous drainage on the choice of a treatment strategy
Authors
Monica Pearl
Juan Gomez
Lydia Gregg
Philippe Gailloud
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 10/2010
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-010-1257-0

Other articles of this Issue 10/2010

Child's Nervous System 10/2010 Go to the issue

Special Annual Issue

Neurosurgical vascular malformations in children under 1 year of age

Special Annual Issue

Neurocutaneous vascular syndromes

Special Annual Issue

Microsurgical management of pediatric intracranial aneurysms

Special Annual Issue

Endovascular management of arteriovenous malformations and other intracranial arteriovenous shunts in neonates, infants, and children

Special Annual Issue

Editorial

Abstracts

38th Annual Meeting of the International Society for Pediatric Neurosurgery, Jeju, South Korea, October 31 to November 4, 2010