Advances in the diagnosis and management of vein of Galen malformations

Todd A. Abruzzo; Lincoln Jimenez; Lauren Ostling; Charles Stevenson; Ravishankar Shivashankar; James L. Leach; Blaise Jones

doi:10.3233/PNR-13063

Journal of Pediatric Neuroradiology, Table of Contents

Journal of Pediatric Neuroradiology 2013; 02(03): 237-261
DOI: 10.3233/PNR-13063

Review Article

Georg Thieme Verlag KG Stuttgart – New York

Advances in the diagnosis and management of vein of Galen malformations

Todd A. Abruzzo

^aDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^bDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^cCincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

^dMayfield Clinic, Cincinnati, OH, USA

,

Lincoln Jimenez

^aDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^bDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

,

Lauren Ostling

^aDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

,

Charles Stevenson

^aDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^cCincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

,

Ravishankar Shivashankar

^aDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^bDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

,

James L. Leach

^bDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^cCincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

,

Blaise Jones

^bDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

^cCincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

› Author Affiliations
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Abstract

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Abstract

The vein of Galen malformations are a heterogeneous group of developmental arteriovenous shunt lesions characterized by arterialization of the early embryonic choroidal venous circulation. The arteriovenous shunt lesion manifests a spectrum of age dependent clinical phenotypes each of which expresses a wide range of disease severity. Clinical presentation is determined by lesion specific, host specific and environmental factors. In recent years, patient oriented treatment strategies directed at optimizing cardiovascular and neurodevelopmental outcomes have evolved. Treatment is tailored to address specific clinical phenotypes that are differentiated according to their pathophysiology. This paper will review current approaches to the diagnosis and treatment of vein of Galen malformations patients emphasizing clinical phenotypes of the fetus, neonate and infant.

Keywords

Vascular malformations - vein of Galen malformations - therapeutic embolization

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