Radiological and clinical features of vein of Galen malformations

被引：25

作者：

Chow, Maggie L. ^{[1
]}

Cooke, Daniel L. ^{[2
]}

Fullerton, Heather J. ^{[3
]}

Amans, Matthew R. ^{[2
]}

Narvid, Jared ^{[2
]}

Dowd, Christopher F. ^{[2
]}

Higashida, Randall T. ^{[2
]}

Halbach, Van V. ^{[2
]}

Hetts, Steven W. ^{[2
]}

机构：

[1] Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA

[2] Univ Calif San Francisco, Dept Intervent Neuroradiol, San Francisco, CA 94143 USA

[3] Univ Calif San Francisco, Dept Neurol & Pediat, San Francisco, CA USA

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2015年 / 7卷 / 06期

关键词：

Pediatrics; Angiography; Arteriovenous Malformation; Intervention;

D O I：

10.1136/neurintsurg-2013-011005

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Background Vein of Galen malformations (VOGMs) are rare and complex congenital arteriovenous fistulas. The clinical and radiological features of VOGMs and their relation to clinical outcomes are not fully characterized. Objective To examine the clinical and radiological features of VOGMs and the predictors of outcome in patients. Methods We retrospectively reviewed the available imaging and medical records of all patients with VOGMs treated at the University of California, San Francisco between 1986 and 2013. Radiological and clinical features were identified. We applied the modified Rankin Scale to determine functional outcome by chart review. Predictors of outcome were assessed by (2) analyses. Results Forty-one cases were confirmed as VOGM. Most patients (78%) had been diagnosed with VOGM in the first year of life. Age at treatment was bimodally distributed, with predominantly urgent embolization at <10days of age and elective embolization after 1year of age. Patients commonly presented with hydrocephalus (65.9%) and congestive heart failure (61.0%). Mixed-type (31.7%) VOGM was more common in our cohort than purely mural (29.3%) or choroidal (26.8%) types. The most common feeding arteries were the choroidal and posterior cerebral arteries. Transarterial embolization with coils was the most common technique used to treat VOGMs at our institution. Functional outcome was normal or only mildly disabled in 50% of the cases at last follow-up (median=3years, range=0-23years). Younger age at first diagnosis, congestive heart failure, and seizures were predictive of adverse clinical outcome. The survival rate in our sample was 78.0% and complete thrombosis of the VOGM was achieved in 62.5% of patients. Conclusions VOGMs continue to be challenging to treat and manage. Nonetheless, endovascular approaches to treatment are continuing to be refined and improved, with increasing success. The neurodevelopmental outcomes of affected children whose VOGMs are treated may be good in many cases.

引用

页码：443 / 448

页数：6

共 33 条

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