Anatomical Subcategorization for Pediatric Vein of Galen Aneurysmal Dilatation

Neuroradiology Journal - Tập 20 Số 5 - Trang 551-561 - 2007
Yusuke Iizuka1,2, Takanori Kakihara1,2, Nobuyuki Yoshimura1,2, T. Kimizuka1,2, Yuka Sumi1,2, Kazunari Kaneko3,4,5
1Department of Radiology, Chiba Japan
2Division of Neuroradiology
3Chiba, Japan
4Department of Pediatric
5Department of Pediatric; Juntendo Urayasu Hospital, Juntendo University, School of Medicine; Chiba Japan

Tóm tắt

Vein of Galen aneurysmal dilatation is generally considered an abnormal deep-seated arteriovenous shunt that drains into the Vein of Galen. We herein present three pediatric cases of vein of Galen aneurysmal dilatation (VGAD). The locations of these shunts are anatomically different from just parenchymal as previously reported, but are also cisternal and intraventricular. Clinical symptoms, neuroradiological diagnostic points and therapeutic endovascular management are reported. Three boys had abnormal findings on brain computed tomography. Using magnetic resonance images, magnetic resonance angiography, three dimensional computed tomographical angiography and digital subtraction angiography, these patients were diagnosed with VGAD. The different locations of their shunts were the intraventricular choroidal plexus, cistern verum interpositive, and thalamus pulvinar nucleus. The boy presenting a single hole arteriovenous shunt at the cistern verum interpositive and an arteriovenous malformation at the choroidal plexus in the left lateral ventricle were treated by endovascular glue embolization. The patient with a single hole fistula in the left thalamus was followed only with observation. Treated patients had their abnormal shunts closed without any neurological complications. VGADs should be classified by shunt location according to whether they are ventricular, cisternal, or parenchymal. Although the therapeutic decision for pediatric VGAD should consider individual radiological, clinical and familial factors, endovascular intervention should be chosen as a first therapeutic option. Endovascular management of these lesions result in excellent angiographic and clinical outcome.

Từ khóa


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Thông tin
Thông tin xuất bản

Neuroradiology Journal

Tập 20 Số 5

551-561

Thông tin tác giả