The management of vein of Galen aneurysmal malformations.

摘要: Objective The vein of Galen aneurysmal malformation (VGAM) is a choroidal type arteriovenous involving the forerunner. This distinct from an with venous drainage into dilated, but already formed, Galen. Reports endovascular treatment VGAM in literature approach disease purely technical viewpoint and often fail to provide satisfactory midterm results. To focus therapeutic challenge strictly morphological goal overlooks fundamental aspects neonatal infant anatomy fluid physiology. During past 20 years, our has remained same. Our experience, based on 317 patients who were studied Hospital Bicetre between October 1981 2002, allows us describe angioarchitecture, natural history, management neonates, infants, children. Methods Of cohort patients, 233 treated embolization; these, 216 hospital. method choice was transfemoral arterial deliver glue at fistulous zone. Results 23 died despite or because embolization (10.6%). Twenty out 193 (10.4%) surviving severely retarded, 30 (15.6%) moderately 143 (74%) neurologically normal follow-up. Conclusion data demonstrate that most children survive undergo neurological development; understanding clinical, anatomical, pathophysiological features has, therefore, reversed former poor prognosis. level about lesion predict situations remedy them by applying strict evaluation protocol working within optimal window. Patient selection timing remain keys this condition. It more important restore growth conditions than appearance, primary objective being development child without deficit.