Presentation, course, and outcome of postneonatal presentations of vein of Galen malformation: a large, single‐institution case series
| Autor: | Vignesh Gopalan, Claire Toolis, Vijeya Ganesan, Fergus Robertson, Sanjay Bhate, Adam Rennie, Lakshmi Kanagarajah |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty medicine.medical_treatment Logistic regression 03 medical and health sciences 0302 clinical medicine Developmental Neuroscience 030225 pediatrics medicine Humans Embolization Child Retrospective Studies medicine.diagnostic_test business.industry Endovascular Procedures Brain Infant Magnetic resonance imaging Retrospective cohort study medicine.disease Magnetic Resonance Imaging Cerebral Angiography Hydrocephalus Treatment Outcome Child Preschool Radiological weapon Vein of Galen Malformations Pediatrics Perinatology and Child Health Cohort Female Neurology (clinical) Tomography X-Ray Computed business 030217 neurology & neurosurgery Cerebral angiography |
| Zdroj: | Developmental Medicine & Child Neurology. 60:424-429 |
| ISSN: | 1469-8749 0012-1622 |
| DOI: | 10.1111/dmcn.13676 |
| Popis: | Aim To describe presentation, clinical course, and outcome in postneonatal presentations of vein of Galen malformation (VGM). Method Children older than 28 days presenting with VGM (from 2006-2016) were included. Notes/scans were reviewed. Outcome was dichotomized into 'good' or 'poor' using the Recovery and Recurrence Questionnaire. Logistic regression was performed to explore relationships between clinico-radiological features and outcome. Results Thirty-one children (18 males, 13 females) were included, presenting at a median age of 9.6 months (range 1.2mo-11y 7mo), most commonly with macrocrania (n=24) and prominent facial veins (n=9). Seven had evidence of cardiac failure. VGM morphology was choroidal in 19. Hydrocephalus (n=24) and loss of white matter volume (n=15) were the most common imaging abnormalities. Twenty-nine patients underwent glue embolization (median two per child). Angiographic shunt closure was achieved in 21 out of 28 survivors. Three children died of intracranial haemorrhage (1y, 6y, and 30d after embolization). Ten patients underwent neurosurgical procedures; to treat haemorrhage in four, and hydrocephalus in the rest. Outcome was categorized as good in 20 out of 28 survivors, but this was not predictable on the basis of the variables listed above. Interpretation Postneonatally presenting VGM has distinctive clinico-radiological features, attributable to venous hypertension. Endovascular treatment is associated with good outcomes, but more specific prognostic prediction was not possible within this cohort. What this paper adds Clinical and radiological features in older children with vein of Galen malformation relate to venous hypertension. Outcome is good in most cases with endovascular therapy. Mortality is low but is related to intracranial haemorrhage. |
| Databáze: | OpenAIRE |
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