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PubMed2000

Spontaneous thrombosis of a vein of Galen aneurysmal malformation: possible effects of contrast media.

A 5-year-old boy with macrocephaly and mental retardation was referred for radiologic evaluation. After cranial CT and MR imaging, the diagnosis of mural type vein of Galen aneurysmal malformation was established by angiography. Two weeks later, preembolization angiography revealed complete thrombosis of the malformation. Although it is a very rare event, vein of Galen aneurysmal malformation may spontaneously thrombose following diagnostic angiography. Possible effects of contrast media on thrombosis were discussed.

Cerebral Angiography↗

PubMed2001

Perfusion brain scintigraphy studies in infants and children with malformations of the vein of Galen.

Cerebral perfusion brain scintigraphy obtained in six unselected patients (age newborn to 14 years) from among 50 children with vein of Galen malformations was used in conjunction with magnetic resonance imaging to determine the basis of the neurological and cognitive abnormalities in patients with vein of Galen malformations (VGMs). Five had a hemiparesis - persistent, transient, or alternating. Four were developmentally delayed. Two had so far been cognitively normal and acquired a neurological deficit, following an embolization procedure. The school age patient had a nonverbal learning disability. Three had epilepsy and/or an abnormal electroencephalogram. Magnetic resonance imaging documented only the VGM, hydrocephalus and atrophy; one child with perinatal asphyxia had periventricular leukomalacia. Perfusion brain scintigraphy was normal in two (a normal infant, and a toddler with a hemiparesis and aphasia). Abnormal findings included: left parietal hypoperfusion, fronto-temporal atrophy, patchy flow; left fronto-temporal hypoperfusion, left hemiatrophy, bilateral medial temporal hypoperfusion, right cerebellar hypoperfusion; right temporal hypoperfusion, patchy flow; right hemiatrophy, occipital hypoperfusion. Perfusion brain scintigraphy findings correlated better with focal neurological and cognitive defects than did magnetic resonance imaging.

Adolescent↗

PubMed1988

The expert system language GALEN.

GALEN is an expert system language based upon nonmonotonic logic and sorted higher-order quantificational logic. It is designed to permit the composition of expert systems for computerized electrocardiographic diagnosis. Using GALEN, a cardiologist will be able to supplement or replace the commercially available computer-assisted ECG diagnostic systems with diagnostic criteria of his or her own for research and clinical uses.

Diagnosis, Computer-Assisted↗

PubMed1989

Radical surgery of a galenic aneurysm with regional cerebral blood flow analysis. A case report.

Successful surgical treatment of a case of aneurysm of the vein of Galen is presented. An 11-month-old boy was admitted with episodes of convulsive attacks. Neuroradiological examination revealed an aneurysm of the vein of Galen filled by branches of posterior cerebral arteries and left thalamoperforating artery. Regional cerebral blood flow, which was measured by a method of xenon-enhanced computed tomography, showed a low flow area in the frontal and occipital regions. The aneurysm was approached through the bilateral parietooccipital interhemisphere, freed from the feeders, and ligated. During the operation, cortical blood flow was monitored for prevention of normal perfusion pressure breakthrough. After the feeders were successfully clipped, the blood flow increased and became normalized in the related cortex. There was no postoperative neurological deterioration.

Arteriovenous Fistula↗

PubMed1990

Vein of Galen aneurysm presenting with recurrent aseptic meningitis and subsequent spontaneous thrombosis.

Clinical and laboratory findings are described in the case of a patient with a vein of Galen aneurysm who presented with recurrent aseptic meningitis for which no etiology could be identified. The patient subsequently developed thalamic and intraventricular hemorrhage associated with partial thrombosis of the dilated vein of Galen. Review of the literature revealed no previously reported association of these conditions. Recurrent cerebral venous thrombosis involving the fistula is hypothesized as the cause of repeated inflammatory reactions near the subarachnoid space. More extensive thrombosis may then have precipitated the hemorrhage.

Adult↗

PubMed1991

Arteriovenous malformations of the vein of Galen: report of three microsurgically treated cases.

Three cases of arteriovenous malformations of the vein of Galen were operated on without mortality and morbidity. Postoperative angiography confirmed total occlusion of the fistulas in each case. Microsurgical operation in the parieto-occipital region with interhemispheric approach was performed to cut the numerous feeders. The procedure was terminated when the sac was diminished in size with bipolar coagulation and clipped with encircling clips to preserve the flow through the vein of Galen. In spite of the good surgical results, the long-term outcome in the two pediatric patients was discouraging because of mental retardation caused by the arteriovenous malformation itself.

Cerebral Veins↗

PubMed1996

Vein of Galen aneurysmal malformation in an adult: a case report.

We report a 19-year old woman with a choroidal-type vein of Galen aneurysmal malformation who presented with hydrocephalus. This venous malformation was fed by multiple fistulas and drained into the superior sagittal sinus through a persistent falcine sinus (precursor of the straight sinus). The hydrocephalus was treated by ventriculoperitioneal shunting, and the patient remained well for 9 years. At this time, magnetic resonance imaging (MRI) and magnetic resonance angiography demonstrated a vein of Galen aneurysmal malformation in the right thalamus, with a Chiari I appearance. This case may provide valuable data regarding the natural history of such venous malformations.

Adult↗

PubMed1992

Arteriovenous malformation of the vein of Galen: a rare cerebral arteriovenous malformation.

A 32-year-old male presented to the emergency department for evaluation of a 12-day history of altered mental status. Workup revealed the presence of an arteriovenous malformation (AVM) of the great vein of Galen, an exceedingly rare and often fatal type of cerebral vascular malformation. Concurrent aneurysmic dilatation of the vein, a frequent finding associated with this type of AVM, resulted in compression of the aqueduct of Sylvius and acute hydrocephalus. A brief review of cerebral AVMs is presented, with specific attention to the pathophysiology, clinical presentation, and emergent treatment of those that involve the vein of Galen.

Adult↗

PubMed2004

Spontaneous thrombosis of vein of Galen aneurysmal malformation after ventriculoperitoneal shunting.

Aneurysmal dilatation of the vein of Galen (AVG) is a common finding in vascular malformations that involve the Galenic system and spontaneous thrombosis is very rare. Although the presentation of the cases may differ with the age, the mortality and morbidity is high in all age groups. Here, we present a case of AVG in a six-month-old boy. The patient underwent insertion of a ventriculoperitoneal shunt. Surveillance of the lesion with subsequent MRI revealed spontaneous thrombosis of the AVG with excellent clinical outcome. Proposed mechanisms of spontaneous thrombosis include slow flow shunts, obstruction of the venous outflow or obstruction of the feeding artery. The case is discussed with the relevant literature.

Central Nervous System Vascular Malformations↗

PubMed1996

Cognitive dysfunction following arteriovenous malformation of the vein of Galen: a case analysis.

Arteriovenous malformation of the vein of Galen (AMVG) has been associated with poor prognosis secondary to its cerebral steal effect. This report describes the cognitive profile of a 38-year-old man who presented to acute rehabilitation with a congenital vein of Galen malformation. Cognitive and behavioral impairments are described and correlated with neuroanatomic involvement. Physiatrists and allied health care professionals must recognize that with the improvement of neurosurgical technology, AMVG can be associated with favorable short-term rehabilitation outcome. Prospective studies are needed to determine long-term outcome.

Adult↗

PubMed2002

Determination of melatonin in galenic preparations by LC and voltammetry.

The amount of melatonin in galenic tablets was determined by means of two feasible and accurate analytical methods. The high performance liquid chromatography (HPLC) with ultraviolet detection at 223 nm used a C(18) reversed-phase column; the linear scan voltammetric procedure (LSV) employs a pH 3.0 phosphate buffer as the supporting electrolyte for the oxidation process of melatonin, which has a current intensity maximum at +850 mV. The two methods gave satisfactory results in terms of precision and accuracy. In fact, the data of repeatability and intermediate precision expressed as percentage relative standard deviations (RSD%) were < or =2.8 and the accuracy values, resulting from recovery experiments, were between 99.0 and 101.3%. Both methods are suitable for quality control of melatonin in galenic preparations; the LSV procedure is more rapid, the HPLC method is more sensitive and more precise.

Antioxidants↗

PubMed1999

Syntactic-semantic tagging as a mediator between linguistic representations and formal models: an exercise in linking SNOMED to GALEN.

Natural language understanding applications are good candidates to solve the knowledge acquisition bottleneck when designing large scale concept systems. However, a necessary condition is that systems are built that transform sentences into a meaning representation that is independent of the subtleties of linguistic structure that nevertheless underly the way language works. The Cassandra II syntactic-semantic tagging system fulfills this goal partially. Within the GALEN-IN-USE project, it is used to transform linguistic representations of surgical procedure expressions into conceptual representations. In this paper, the proctology chapter of the SNOMED V3.1 procedure axis was used as a testbed to evaluate the usefulness of this approach. A quantitative and qualitative analysis of the data obtained is presented, showing that the Cassandra system can indeed complement the manual modelling efforts being conducted in the GALEN-IN-USE project. The different requirements related to linguistic modelling versus conceptual modelling can partly be accounted for by using an interface ontology, of which the fine tuning will however remain an important effort.

Artificial Intelligence↗

PubMed2002

Vein of Galen technique for occluding the aneurysmal sac of pulmonary arteriovenous malformations.

In seven of 255 consecutive patients (2.7%) who underwent pulmonary arteriovenous malformation (PAVM) embolization at our center between July 1, 1996, and July 1, 2000, the feeding artery was considered too short for safe occlusion with use of standard stainless-steel coils or detachable balloons. These patients were successfully treated with use of a modified vein of Galen technique similar to the one used for managing intracranial vein of Galen aneurysms. In this article, the authors report their experience with this technique in safely occluding the aneurysmal sacs of PAVMs in patients with short (<2 cm) feeding pulmonary arteries.

Adult↗

PubMed2000

GALEN: a third generation terminology tool to support a multipurpose national coding system for surgical procedures.

Generalised architecture for languages, encyclopedia and nomenclatures in medicine (GALEN) has developed a new generation of terminology tools based on a language independent model describing the semantics and allowing computer processing and multiple reuses as well as natural language understanding systems applications to facilitate the sharing and maintaining of consistent medical knowledge. During the European Union 4 Th. framework program project GALEN-IN-USE and later on within two contracts with the national health authorities we applied the modelling and the tools to the development of a new multipurpose coding system for surgical procedures named CCAM in a minority language country, France. On one hand, we contributed to a language independent knowledge repository and multilingual semantic dictionaries for multicultural Europe. On the other hand, we support the traditional process for creating a new coding system in medicine which is very much labour consuming by artificial intelligence tools using a medically oriented recursive ontology and natural language processing. We used an integrated software named CLAW (for classification workbench) to process French professional medical language rubrics produced by the national colleges of surgeons domain experts into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation, on one hand, we generate with the LNAT natural language generator controlled French natural language to support the finalization of the linguistic labels (first generation) in relation with the meanings of the conceptual system structure. On the other hand, the Claw classification manager proves to be very powerful to retrieve the initial domain experts rubrics list with different categories of concepts (second generation) within a semantic structured representation (third generation) bridge to the electronic patient record detailed terminology.

Abstracting and Indexing↗

PubMed1995

Prenatal sonographic diagnosis of a vein of Galen aneurysm: relevance of associated malformations for timing and mode of delivery.

The term 'aneurysm of the vein of Galen' encompasses a range of different midline arteriovenous fistula malformations. Prenatal real-time and Doppler sonography can contribute to the differential diagnosis of fetal cerebral cystic lesions of various origins, pineal and choroid tumors, and intracerebral hematoma. Regardless of the type of treatment, perinatal morbidity and mortality are high, often due to cardiac failure. A case of spontaneous delivery at 36 weeks of gestation by a 30-year-old woman presenting with a fetal aneurysm of the vein of Galen is described. As the extrauterine cardiac function was normal and a steal phenomenon was not present, expectant management was justified. Five arterial embolizations within the following 4 years were performed as a means of treating the primary lesion. Our case illustrates the fact that elective spontaneous vaginal delivery followed by serial embolization is possible in cases of arteriovenous fistula malformation without signs of cardiac insufficiency.

Adult↗

PubMed2000

Prenatal diagnosis of an aneurysm of the vein of Galen with three-dimensional color power angiography.

The prenatal diagnosis of an aneurysm of the vein of Galen has been reported on only a few occasions. This rare arterio-venous fistula is suspected when an intracerebral hypoechoic cyst is found in which blood flow can be demonstrated by Doppler ultrasound. This is one of the few conditions where Doppler ultrasound is critical for the diagnosis. Three-dimensional color power Doppler (3D-CPA) is a recent ultrasound modality which enables the three-dimensional visualization of vessels and which is more readily available than magnetic resonance imaging (MRI) We report a fetus in which an aneurysm of the vein of Galen was detected at 33 weeks' gestation and where the application of 3D-CPA enabled a better understanding of the spatial orientation and course of the dilated vessels. The neonate was successfully treated with coil angiography but subsequently died at 5 months of age from cardiac decompensation. Where fetal malformations involve the vascular system, 3D-CPA appears to be a promising technique.

Adult↗

PubMed1991

Prenatal diagnosis of the aneurysm of the vein of Galen by pulsed Doppler unit.

Aneurysm of the vein of Galen is a rare anomaly. In the severe type, the first clinical manifestation of this anomaly is heart failure after birth. Prenatal diagnosis is important in preventing heart failure during the postnatal period. Here, we report the prenatal diagnosis of a case of aneurysm of the vein of Galen in which we used a pulsed Doppler unit combined with a fetal electrocardiogram-phonocardiogram unit.

Adult↗

PubMedDate not supplied

Modelling and reclassification of surgical procedures--experiences from the use of GALEN methods in the domain of thoracic surgery.

This paper reports on experiences from the evaluation of GALEN methods for mapping of follow-up categories in the domain of thoracic surgery to an existing classification of surgical procedures. The mapping of the aggregated levels or groups of thoracic procedures presents a genuine problem in relation to strict hierarchical classifications, since the follow-up categories do not necessarily fit in the pre-set structure of the classification. Experiences from modelling of the traditional classification and of the follow-up categories are reported, and an analysis of the results is presented along with a discussion of opportunities and potential problems and pitfalls when applying GALEN models and tools.

Cardiac Surgical Procedures↗