Hemodynamic disturbances associated with endovascular embolization in newborn infants with vein of Galen malformation

Journal of Perinatology : Official Journal of the California Perinatal Association
F Y WongP Loughnan

Abstract

To examine hemodynamic changes following endovascular embolization in newborn infants with vein of Galen malformation and severe cardiac failure in the first week of life. Over a recent 5-year period, nine such infants were identified. In seven of these infants, changes in arterial blood pressure were analyzed in relation to the timing of embolization procedures. A significant increase in arterial blood pressure was noted after most embolizations. In two infants, this systemic hypertension was severe and treated using intravenous antihypertensive drugs. Both infants subsequently developed complete infarction of both cerebral hemispheres with sparing of the brainstem and cerebellum. Mortality in the nine infants was 33%, and 83% of the survivors were neurologically normal or near normal at follow-up. The systemic hypertension observed following endovascular embolizations may provide a protective mechanism to maintain cerebral blood flow after reperfusion injury. Lowering blood pressure in this situation may therefore be detrimental.

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Citations

Sep 18, 2012·Neuroradiology·Francisco Brevis NuñezChristian Dohna-Schwake
Nov 3, 2010·Journal of Neurosurgery. Pediatrics·Dhruv KhullarKetan R Bulsara
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Aug 24, 2021·Expert Review of Medical Devices·Panagiotis PrimikirisChristina Iosif

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