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At least 217 records · Page 12Linked to original sources
PubMed1994

Prognosis of antenatally diagnosed vein of Galen aneurysmal malformations.

In our experience of 168 consecutive cerebral arteriovenous shunts, all antenatally diagnosed lesions were vein of Galen aneurysmal malformations (VGAMs). This series consists of 18 cases of VGAMs detected by ultrasound during the third trimester of pregnancy. There were 12 normal vaginal deliveries, 5 deliveries by cesarean section, and 1 induced abortion. Sixteen newborns (94%) presented with systemic cardiac manifestations as the first clinical symptoms; 12/16 were managed effectively by digitalo-diuretic treatment, while 4 (25%) died shortly after birth from acute heart and/or multiorgan failure with extensive brain damage. Twelve babies underwent embolization via the arterial route in infancy (2 at 2 months of age). Total exclusion was obtained in 8 babies (67%, 3 with 6 months follow-up). Furthermore, 67% of the newborns managed by our team are neurologically normal (Denver and Brunet-Leizine tests). These results emphasize that the pessimism that follows antenatal discovery of these lesions and the previous assumption of a bad prognosis for VGAMs can nowadays be reviewed in the light of transarterial endovascular therapy applied according to a strict clinicoradiological protocol. Interventions in the neonatal period are rarely required. Generally, poorly timed mechanical therapy should be discouraged.

Algorithms↗
PubMed1991

Vein of Galen malformation. Endovascular management of 43 cases.

Since 1984, 43 patients with true vein of Galen aneurysmal malformations have been referred to us and managed according to our patient selection, technique, and follow-up guidelines. Thirty-four were embolized transarterially with bucrilate (isobutyl cyanoacrylate) or enbucrilate (N-butyl cyanoacrylate) embolization. No cutdown or hypotension during or after the embolization was used and no balloon catheter was employed. Forty-seven percent of the children had a completely occluded lesion which was confirmed when the child was at least 6 months of age at the follow-up angiographic examination; 52.9% were found to be completely normal or only to have mild cardiac failure that could be treated medically or moderate macrocephaly without neurological symptoms or mental retardation. In the embolized group 5.8% died as a result of the wrong treatment (1 case) or poor timing of embolization 3 days after ventricular shunting (1 case). The overall mortality (embolized and non-embolized groups) in the neonatal children was 27.7% with a total of 18.6% for all ages. Complete morphological exclusion of the arteriovenous malformation was accomplished in 41.9%; 74.4% of all children referred are now clinically normal or present moderate mental retardation which is diminishing. There was 3% neurological morbidity in the embolized group (only following the venous approach) in 78 sessions and more than 100 arteries embolized. These results compare favorably with surgical or other techniques of arterial embolization (balloon or particles), as well as transvenous (transtorcular or transfemoral) embolization, where the morbidity and mortality are significantly higher and the late clinical evaluation is seldom satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Comparison of the effects of two different galenical preparations of glyceryl trinitrate on pulmonary artery pressure and on the finger pulse curve.

The time course and the magnitude of the effect of glyceryl trinitrate (GTN) on central venous (pulmonary artery diastolic pressure-PAPd) and peripheral arterial (a/b-ratio of the finger pulse wave) haemodynamics were compared in a randomized double-blind cross-over study in 12 patients suffering from congestive heart failure (NYHA II-III) with elevated PAPd at rest (> or = 15 mmHg). The data were obtained in a bioavailability study of two sprays of glyceryl trinitrate, which differed in their galenical characteristics and in the dose of GTN (0.4 mg vs. 0.8 mg). Following sublingual administration of each spray, PAPd, a/b-ratio and the plasma concentrations of GTN and its metabolites were measured up to 30 min. The relative bioavailability of GTN of the test preparation was estimated to be 157%, 161% and 147%, when calculated from the plasma concentration-time data or the integrated effect of GTN on a/b-ratio or PAPd, respectively. The mean time courses of the decrease in PAPd and the increase in the a/b-ratio of the finger pulse curve were mirror images. Thus, there was a strong correlation between the mean values of PAPd and a/b-ratio following the administration of glyceryl trinitrate. Since the slope of the relationship differed considerably between the patients, the magnitude of effect of GTN on PAPd in the individual patient could not be predicted from the changes in a/b-ratio.

Adult↗
PubMed1984

In utero diagnosis of a vein of Galen aneurysm by ultrasound.

A large midline supratentorial cystic lesion with associated cardiomegaly was seen in utero by ultrasound during the 34th week of pregnancy. The provisional diagnosis of a vein of Galen aneurysm was confirmed with CT and angiography after birth.

Adult↗
PubMed1981

Aneurysms of the vein of Galen in infants aged 2 to 15 months. Diagnosis and natural evolution.

This is a report of seven cases of aneurysm of the vein of Galen (AVG) with a review of the clinical and radiological aspects of 48 cases in the literature. The natural evolution and pathophysiology of this vascular malformation are discussed. The clinical signs of this condition are often misleading. The appearance of AVG on CT is pathognomic. Surveillance of the vascular malformation and associated cerebral lesions can be maintained with subsequent CT. Spontaneous thrombosis of the aneurysm was observed in three cases. The diagnosis of thrombosis of the AVG was always made at operation or by histological examination. The radiological appearance of a thrombosed aneurysm is typical.

Cerebral Angiography↗
PubMed1978

CT scan and gas encephalography in diagnosis of arachnoid cyst and epidermoid cyst of Galen's cistern.

The CAT scan is insufficient to make the differential diagnosis between an arachnoid cyst and an epidermoid cyst in the cistern of Galen. Gas encephalography is necessary. This procedure reveals arachnoid cysts of the commmunicating type, but is insufficient in distinguishing between an epidermoid cyst and a non-communicating arachnoid cyst. In this situation, histograms of the absorption values in each section of the lesion may be helpful for the diagnosis.

Arachnoid↗
PubMed1981

[8-Methoxypsoralen (8-MOP)-a new galenic form and its relation to 8-MOP serum levels (author's transl)].

A bioequivalence study was performed with two different 8-MOP preparations. Thirty-eight patients participated in the investigation. We compared a product already marketed containing a micronized powder in hard gelatine capsules with a new product in soft gelatine capsules containing the 8-MOP in a solution. With the new galenic preparation the serum level obtained was 3.2 (P less than or equal to 0.01) times higher than with the old product. Thus, the improved resorption out of the solution was mainly responsible for these results.

Dosage Forms↗
PubMed1990

The role of ultrasound in the management of vein of Galen aneurysms in infancy.

Ultrasonography can be the key imaging modality for neonatal patients with vein of Galen aneurysms. Ultrasound can be used to diagnose the condition, monitor transtorcular embolization procedures, and follow-up these patients after embolization to assess the effectiveness of embolization and to check for complications.

Cerebral Angiography↗
PubMed1991

Acquired mural (dural) arteriovenous shunts of the vein of Galen. Report of 4 cases.

4 patients with acquired arteriovenous shunts located in the wall of an ectatic vein of Galen (VG) are reported. They represent so-called VG dural arterio-venous malformations (DAVM). These shunts involve the vasa vasorum normally present in the VG wall. Physiopathology, clinical signs and age groups are usually the same as those encountered in other DAVMs; conversely they are totally different from the other mural shunts of the VG, detected in the pediatric population (true VG arteriovenous malformations), and leading to different clinical symptoms. Venous approach in these VG DAVMs is almost always contraindicated unless secondary occlusion of VG afferent has spontaneously excluded the pouch from the cerebral venous circulation.

Adult↗
PubMed1990

Colour Doppler imaging of arteriovenous malformation of the vein of Galen in a newborn.

We report a neonate with congestive heart failure due to a huge arteriovenous malformation of the vein of Galen. Two dimensional ultrasound showed a large cystic structure behind the 3rd ventricle and the quadrigeminal plate. The cyst compressed the posterior part of the 3rd ventricle and the aqueduct and caused an obstructive hydrocephalus. The diagnosis was established by colour Doppler imaging (CDI). With the help of CDI, flow within the aneurysm could be shown as well as feeding arteries originating from the posterior and middle cerebral arteries. The straight sinus and the torcular Herophili were markedly dilated.

Cerebral Veins↗
PubMed1993

Prenatal brain atrophy due to a giant vein of Galen malformation.

We report a full-term newborn girl with a giant vein of Galen malformation and extreme cerebral atrophy of prenatal origin. She presented on the 3rd day of life with intractable congestive heart failure. The diagnosis of the vascular malformation was confirmed by ultrasound and magnetic resonance imaging.

Atrophy↗
PubMed1987

Arteriovenous malformation of the great cerebral vein (of Galen) in a newborn. Diagnosis by ultrasound and digital subtraction angiography.

This is a report of a case with an arteriovenous (a.v.) malformation of the great cerebral vein. Applicable diagnostic procedures are reviewed. The initial diagnostic procedure in the approach to an a.v. malformation of the great vein of Galen is cerebral ultrasound. The findings in our patient are compared with those reported in the literature.

Cerebral Angiography↗
PubMed1995

Transarterial embolization of vein of Galen aneurysmal malformation after unsuccessful stereotactic radiosurgery. Report of three cases.

The authors present three cases of vein of Galen aneurysmal malformations (VGAMs) diagnosed in infancy and submitted by the referring teams for stereotactic radiosurgery as the initial therapy (therapeutic doses ranging between 20-25 Gy and 40-50 Gy to the peak dose). After the conventional follow-up of 18-24 months, no change could be detected in the angioarchitecture of the lesions. All three cases were then referred for endovascular treatment and underwent embolization by the transarterial route using liquid adhesives (N-butyl cyanoacrylate). This resulted in complete anatomical exclusion of the lesion. Regardless of the theoretical efficiency of radiosurgery in the management of brain arteriovenous malformations, the present authors believe that transarterial embolization remains the treatment of choice in VGAMs. It offers a high rate of morphological cure and the best chances for normal neurocognitive development. The time required by radiosurgery to achieve a significant result is too long for developing and maturing brain and may not prevent the negative effects of the lesion, mainly in regard to hemo- and hydrodynamic disorders (atrophy, subcortical calcifications, etc.) created by the VGAM, thus leading to irreversible mental retardation.

Cerebral Angiography↗
PubMed1982

Periventricular calcifications in a newborn associated with aneurysm of the great vein of Galen.

A newborn infant who presented with heart failure was diagnosed to have an aneurysm of the vein of Galen. Skull radiographs and CT scan demonstrated multiple periventricular calcifications. This case illustrates a new diagnostic possibility for the radiologic finding of periventricular calcifications in the newborn. It also establishes the importance of performing good skull roentgenographic series in all neonates with unexplained heart failure.

Calcinosis↗