PP05.4 – 2566: Developmental outcomes in children treated for vein of Galen malformation

Abstract

Objective To describe the clinical course, developmental outcomes and co-morbidities over the first 6 years of life in children with Vein of Galen Aneurysmal Malformation (VGAM) who were treated with catheter embolisation treatment at a single UK centre between January 2000 and October 2012. Methods Retrospective case review of 28 children who underwent embolisation treatment. 6 children died in the first few weeks of life and were excluded from the data set. Developmental data was collected at key stages: Birth, 6–8 weeks, 3–6m, 12–18m, 24–36m and 48–72m. Data was collected and analysed using the Denver II Developmental Screening Tool and the Bicetre Admission and Outcome Score (VGAM specific tool). The number of embolisations treatments and other clinical morbidities was collected. Results All children treated within the study group survived. Developmental morbidity was present in one or more developmental parameter in all the key stages. The percentage of children presenting with normal development changed across the developmental stages: 95.5% aged 6–8 weeks – 55.5% at 48–72 months using the Denver tool in comparison to 40.9% using the Bicetre Outcome Score. Gross motor delay was the most significant finding in all age groups. Seizures and shunted hydrocephalus were associated with poor outcomes. Conclusion Assessing developmental outcomes at various key stages, provides a clearer understanding of the Neurodevelopmental phenotype of children treated for VGAM. The ability for developmental catch up was noted in some developmental parameters. Clear themes emerged to indicate the importance of co-existing morbidities on developmental outcomes. A multi-disciplinary proactive approach to target services at the point of need is essential to maximise individual children's developmental outcomes.