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

Monica Pearl, Juan Gomez, Lydia Gregg, Philippe Gailloud

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1367-1379
Number of pages13
JournalChild's Nervous System
Volume26
Issue number10
DOIs
StatePublished - Oct 1 2010

Keywords

  • Endovascular techniques
  • Internal cerebral veins
  • Vascular malformation
  • Vein of Galen anomaly
  • Venous anatomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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