Galen vein aneurysm malformation in pediatric patients: from diagnosis to treatment

Authors

DOI:

https://doi.org/10.33448/rsd-v11i4.27105

Keywords:

Malformations of the vein of galen; Cerebral veins; Aneurysm; Pediatrics; Therapeutic embolization; Microsurgery; Endovascular procedures.

Abstract

Arteriovenous malformation of the vein of Galen named after Galen of Pergamum (gr. Γαληνός, also known as Aelius Galenus or Claudius Galenus) (129-199 AD), accounts for 1% of intracranial vascular malformations. It is characterized by marked dilatation of the vein of Galen, containing multiple arteriovenous fistulas that open into a middle vein of the forebrain called the vein of Markowski, precursor of the vein of Galen. During the perinatal period, the first clinical manifestation is usually heart failure, often in the first day or two of life, and may also present with hydrocephalus, unusually prominent veins on the face and scalp, developmental delays, persistent headache. and in very rare cases, a hemorrhage in the brain. The causes of Galen vein malformation occur during a baby's early prenatal development, usually during the first trimester, it is not known exactly what causes a MAVG but it is likely to be genetic, MAVG sometimes but not always occurs with vascular anomalies that affect other parts of the body. The diagnosis can be obtained from pregnancy through gestational ultrasound and, later, through transfontanellar ultrasound, magnetic resonance imaging and angiography, which is the standard exam. The best treatment for MAVG is endovascular embolization by the transarterial or transvenous technique, open surgery is reserved for cases of failure of endovascular embolization or associated with it when necessary. Its prognosis is linked to the initial clinic, early diagnosis and surgical correction at the right time.

References

Ahmad, M., Mir, S., Wahab, S., & Rizvi, I. (2012). Vein of Galen malformation. Case Reports, 2012(sep07 1), bcr2012006822–bcr2012006822.

Alexander, M. J., & Spetzler, R. F. (2006). Pediatric neurovascular dissesse: surgical, endovascular, and medical management. Thieme.

Chen, M.-Y., Liu, H.-M., Weng, W.-C., Peng, S.-F., Wu, E.-T., & Chiu, S.-N. (2010). Neonate With Severe Heart Failure Related to Vein of Galen Malformation. Pediatrics & Neonatology, 51(4), 245–248.

Demartini Jr., Z., dos Santos, M. L. T., Koppe, G. L., & Cardoso-Demartini, A. de A. (2017). Sinus Thrombosis after Endovascular Treatment of Vein of Galen Aneurysmal Malformation. Pediatric Neurosurgery, 52(2), 136–139.

Fayyaz A & Qureshi IA. (2005). Vein of galen aneurysm: antenatal diagnosis: a case report. Pesquisa.bvsalud.org, 455–456.

Félix L, Souza AR, Queiroz AP, Diniz C, Lima M & Santos RE, et al. (2010) Ultra-sonografia pré-natal no diagnóstico de aneurisma da veia de galeno. Acta Med Port.;23(3):505-510.

Gailloud, P., O’Riordan, D. P., Burger, I., Levrier, O., Jallo, G., Tamargo, R. J., Murphy, K. J., & Lehmann, C. U. (2005). Diagnosis and Management of Vein of Galen Aneurysmal Malformations. Journal of Perinatology, 25(8), 542–551.

Gupta, A., & Varma, D. (2004). Review Article Vein of Galen malformations: Review. 52.

Hoffman, H. J., Chuang, S., Hendrick, E. B., & Humphreys, R. P. (1982). Aneurysms of the vein of Galen. Journal of Neurosurgery, 57(3), 316–322.

Horowitz, M. B., Jungreis, C. A., Quisling, R. G., & Pollack, I. (1994). Vein of Galen aneurysms: a review and current perspective. AJNR. American Journal of Neuroradiology, 15(8), 1486–1496.

Jones, B. V., Ball, W. S., Tomsick, T. A., Millard, J., & Crone, K. R. (2002). Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up. AJNR. American Journal of Neuroradiology, 23(10), 1717–1724.

Jones, B. V., Ball, W. S., Tomsick, T. A., Millard, J., & Crone, K. R. (2002). Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up. AJNR. American Journal of Neuroradiology, 23(10), 1717–1724.

Karanam, L. S. P., Baddam, S. R., & Joseph, S. (2011). Endovascular management of vein of galen aneurysm malformation: A series of two case reports. Journal of Pediatric Neurosciences, 6(1), 32–35.

Kariyappa, K., Krishnaswami, M., Gnanaprakasam, F., Ramachandran, M., & Krishnaswamy, V. (2016). Spontaneous thrombosis of vein of Galen malformation. Journal of Pediatric Neurosciences, 11(3), 264.

Lasjaunias, P. L., Chng, S. M., Sachet, M., Alvarez, H., Rodesch, G., & Garcia-Monaco, R. (2006). The management of vein of Galen aneurysmal malformations. Neurosurgery, 59(5 Suppl 3), S184-194; discussion S3-13.

Lasjaunias, P., & Al, E. (1997). Vascular diseases in neonates infant and children: interventional neuroradiology management. Springer.

Lin, J., Lfo, H., Vf, P., Knihs, V., Mm, P., & Rjm, S. (2022). Mal-formação da Veia de Galeno: relato de caso. ;34(2):S83-84.

Litvak, J., Yahr, M. D., & Ransohoff, J. (1960). Aneurysms of the Great Vein of Galen and Midline Cerebral Arteriovenous Anomalies. Journal of Neurosurgery, 17(6), 945–954.

Madhuban, A., van den Heuvel, F., & van Stuijvenberg, M. (2016). Vein of Galen Aneurysmal Malformation in Neonates Presenting With Congestive Heart Failure. Child Neurology Open, 3, 2329048X1562470.

Mai, R., Rempen, A., & Kristen, P. (1996). Prenatal diagnosis and prognosis of a vein of Galen aneurysm assessed by pulsed and color Doppler sonography. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 7(3), 228–230.

Mitchell, P. J., Rosenfeld, J. V., Dargaville, P., Loughnan, P., Ditchfield, M. R., Frawley, G., & Tress, B. M. (2001). Endovascular Management of Vein of Galen Aneurysmal Malformations Presenting in the Neonatal Period. AJNR: American Journal of Neuroradiology, 22(7), 1403–1409.

Mortazavi, M. M., Griessenauer, C. J., Foreman, P., Bavarsad Shahripour, R., Shoja, M. M., Rozzelle, C. J., Tubbs, R. S., Fisher, W. S., & Fukushima, T. (2013). Vein of Galen aneurysmal malformations: critical analysis of the literature with proposal of a new classification system. Journal of Neurosurgery. Pediatrics, 12(3), 293–306.

Mortazavi, M. M., Griessenauer, C. J., Foreman, P., Bavarsad Shahripour, R., Shoja, M. M., Rozzelle, C. J., Tubbs, R. S., Fisher, W. S., & Fukushima, T. (2013). Vein of Galen aneurysmal malformations: critical analysis of the literature with proposal of a new classification system. Journal of Neurosurgery. Pediatrics, 12(3), 293–306.

Ribeiro V. T, Botelho L. F, Lopes A. C, Ribeiro P, Xavier J. Á., & Cruz R. (2003) Malformação aneurismática da veia de Galeno do tipo coroidal num adulto associada a malformação de Dandy-Walker. Acta Med Port;16(3):217-220.

Rodesch, G., Hui, F., Alvarez, H., Tanaka, A., & Lasjaunias, P. (1994). Prognosis of antenatally diagnosed vein of Galen aneurysmal malformations. Child’s Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery, 10(2), 79–83.

Yasargil MG Microsurgery. (1988) New York. Time; Journal of Embryology & Developmental Biology p.323-357

Zerah, M., Garcia-Monaco, R., Rodesch, G., Terbrugge, K., Tardieu, M., de Victor, D., & Lasjaunias, P. (1992). Hydrodynamics in vein of Galen malformations. Child’s Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery, 8(3), 111–117; discussion 117.

Zimmermann, A. C., Przysiezny, B., Giustina, E. D., Staedele, G. V., Haas, L. J., Tutida, L. S., & Camilo,L. C. de O. (2021). Vein of Galen Aneurysmal Malformations in Pediatric Patients Submitted to Endovascular Treatment: Report of 3 Cases. Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 40(04), e374–e379.

Published

10/03/2022

How to Cite

PAZ, J. V. C. da .; COSTA, R. M. .; SILVA , A. P. A. .; ALVES, A. P. D. .; CERQUEIRA NETO, J. P. de; ARRIVABENE , K. C. S. .; MELO, S. M. B. de .; ROSÁRIO, L. C. V. do .; LEAL, D. A. P. .; PAVÃO FILHO, J. J. J. . Galen vein aneurysm malformation in pediatric patients: from diagnosis to treatment. Research, Society and Development, [S. l.], v. 11, n. 4, p. e3911427105, 2022. DOI: 10.33448/rsd-v11i4.27105. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/27105. Acesso em: 14 nov. 2024.

Issue

Section

Health Sciences