Zhang Jinwei,Wu Shuihua,Su Jun,et al.Management of vein of Galen aneurysmal malformation with interventional embolization in infants and children: a report of 2 cases with a literature review[J].Journal of Clinical Pediatric Surgery,2025,(02):131-137.[doi:10.3760/cma.j.cn101785-202410066-006]
Management of vein of Galen aneurysmal malformation with interventional embolization in infants and children: a report of 2 cases with a literature review
- Keywords:
- Intracranial Arteriovenous Malformations; Vein Aneurysmal of Galen Malformation; Endovascular Therapy; Embolization; Therapeutic; Child
- Abstract:
- Objective To explore the clinical features,diagnoses and outcomes of interventional embolization for vein of Galen aneurysmal malformation (VGAM) in infants and toddlers. Methods Retrospective review was conducted for the relevant clinical data of two children of VGAM from January 2020 to December 2022.And the literature related to the treatment of VGAM with interventional embolization was searched in PubMed,Wanfang Medical Network and China Knowledge Network from January 2014 to October 2024.Clinical characteristics,stages,diagnoses,treatment protocols and treatment outcomes were summarized. Results Case 1 had a head circumference of 52 cm during a 12-month follow-up period.Development of speech and gross motor improved significantly as compared with preoperative period.Independent ambulation was feasible.Cranial magnetic resonance imaging (MRI) indicated that VGAM significantly diminished as compared with preoperative period.In case 2,head circumference was 53.5 cm during a 12-month follow-up period.Development of speech and language improved as compared with preoperative period.Cranial MRI revealed that VGAM had no change as compared with preoperative period and dilatation of cerebral ventricles improved as compared with preoperative period.The family declined to undergo cerebral angiography and interventional embolization again.The patient was lost to follow-ups.Ten articles retrieved from the literature fulfilled the inclusion and exclusion criteria.A total of 15 cases of VGAM in infants and children treated by interventional embolization were reported along with 2 cases at our hospital.The clinical types were choroidal (n=12) and intramural (n=5).Three cases were detected by ultrasound during pregnancy.The procedures included interventional embolization via venous (n=1),combined embolization via arterial-vein embolization (n=1) and trans-arterial interventional embolization (n=15).There were death (n=1) and residual aneurysm-like malformation (n=3).Curative rate was 76.47%.There were preoperative combined hydrocephalus (n=11),postoperative complete relief (n=7),obvious relief (n=2) and non-relief (n=1). Conclusions VGAM is a very rare intracranial vascular malformation with major clinical manifestations of expanded head circumference,growth retardation and heart failure.Intrapartum ultrasound and fetal magnetic resonance may aid in intrapartum diagnosis.And cerebral angiography is a gold standard for confirming a diagnosis.Interventional embolization is highly efficacious.
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Memo
收稿日期:2024-10-29。
基金项目:湖南省自然科学基金资助项目(2025JJ50682)
通讯作者:吴水华,Email:292454021@qq.com