Radiological and Clinical Features of Vein of Galen Aneurysmal Malformation In Newborn, Endovascular Interventional Treatment Management: 10 Years Experience

Abstract

Objective: To assess the clinical features, diagnosis, management strategies and results of newborns born between the years 2005-2015 with Vein of Galen Malformation (VGAM). Material and Method: Eight newborn patients with diagnosis of VGAM were assessed retrospectively in terms of clinical admission symptoms, diagnosis, treatment strategies and follow-up based on the information retrieved from patient files. Three of four patients who survived had neurological assessment while the information about the remaining patient whose family moved to another city were obtained via phone call. Results: Seven out of 8 patients (1 female, and 7 male patients) had antenatal diagnosis. In all cases severe heart failure and pulmonary hypertension were present from the first days of their life, later on development of hypotension, multiorgan failure, hydrocephalus and seizures was seen. VGAM and its feeder arteries were mapped by cranial magnetic resonance imaging and magnetic resonance angiography. Transarterial embolization therapy was performed successfully in four patients. Despite similar treatment modalities three of these patients died, and one patient was lost before initiation of embolization procedure. Conclusion: VGAM has high mortality and morbidity rates because of its complicated anatomy, pathophysiology leading to severe neurological sequelae. Prognosis in high risk neonates can be improved with aggressive medical support and early endovascular embolization therapy.