Child's Nervous System

, Volume 26, Issue 10, pp 1367–1379

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
Special Annual Issue

DOI: 10.1007/s00381-010-1257-0

Cite this article as:
Pearl, M., Gomez, J., Gregg, L. et al. Childs Nerv Syst (2010) 26: 1367. doi:10.1007/s00381-010-1257-0

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.

Keywords

Vein of Galen anomalyVascular malformationEndovascular techniquesVenous anatomyInternal cerebral veins

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Monica Pearl
    • 1
  • Juan Gomez
    • 1
  • Lydia Gregg
    • 1
  • Philippe Gailloud
    • 1
  1. 1.Division of Interventional NeuroradiologyThe Johns Hopkins HospitalBaltimoreUSA