Abstract
Neonates presenting with intractable cardiac failure due to vein of Galen aneurysmal malformations (VGAMs) rapidly progress to multisystem organ failure and death if left untreated. Currently the only viable treatment option is endovascular embolization. Although intracranial embolization of a neonate is a high-risk procedure, successful treatment can reverse cardiac failure and prevent neurological complications associated with VGAMs. Embolization via the arterial route is thought to have a better outcome than embolization via the venous system. However, multiple transarterial embolizations in different sessions may well be contraindicated in neonates, because repeat access via the femoral artery, carries a risk of arterial trauma which, in turn, can jeopardize lower limbs. With this case study we show that after repeat failure of arterial embolization, the transcranial placement of an Amplatzer PFO occluder (AGA Medical, Plymouth, USA) in the aneurysm can effectively reduce intrafistular pressure and venous outflow velocity. We also propose a mathematical model that can be used to calculate flow velocity through the aneurysm, which, in turn, could be used to aid clinical decision-making. Unlike some conventional techniques, t...Continue Reading
References
May 1, 1992·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·M ZerahP Lasjaunias
Jan 1, 1989·Neuroradiology·C A RaybaudJ K Hald
May 1, 1987·Neurosurgery·I H JohnstonM K Morgan
Sep 1, 1982·Journal of Neurosurgery·H J HoffmanR P Humphreys
Mar 1, 1994·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·G RodeschP Lasjaunias
Mar 1, 1994·Acta Paediatrica·S SwanströmP Lasjaunias
Aug 20, 2002·Intensive Care Medicine·L ChevretP Lasjaunias
Aug 24, 2002·Archives of Disease in Childhood. Fetal and Neonatal Edition·G P FrawleyP Loughnan
Mar 4, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·J J Bhattacharya, J Thammaroj
Nov 26, 2003·Neurology·H J FullertonC F Dowd
Jul 25, 2007·Neuroimaging Clinics of North America·H AlvarezPierre Lasjaunias
Aug 8, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Sasikhan GeibprasertCharles A Raybaud
Nov 3, 2009·Neurosurgical Focus·Stanley HoangRaphael Guzman
Jan 13, 2018·Neurology India·Vipul Gupta, Rajsrinivas Parthasarathy