Abstract
Advances in endovascular embolization have improved morbidity and mortality among patients with vein of Galen malformations (VoGMs). The patient presented at 3 months of age with increased head circumference and a bruit over his anterior fontanelle. Diagnostic cerebral angiography confirmed the presence of a large mural-type VoGM. The decision was made to undergo a staged arterial embolization at 4 years of age after developing worsening right-sided hemiparesis. An attempt was made to occlude the posterior choroidal feeding vessel with a large 25 mm × 50 cm coil, followed by a 6 mm × 20 cm coil; however, the high flow of the lesion displaced both coils into the wall of the aneurysmal venous sac. Interval magnetic resonance imaging and angiography revealed partial occlusion of the VoGM at 7 months and complete thrombosis at 24 months post procedure, precluding a need for additional coiling. This case illustrates that a minimal change in intramural flow dynamics of VoGMs could lead to progressive thrombosis.
Original language | English (US) |
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Pages (from-to) | 296-298 |
Number of pages | 3 |
Journal | World Neurosurgery |
Volume | 116 |
DOIs | |
State | Published - Aug 2018 |
Externally published | Yes |
Keywords
- Complete occlusion
- Single-stage transarterial venous sac embolization
- Transarterial multistage embolization
- Vein of Galen malformations
ASJC Scopus subject areas
- Surgery
- Clinical Neurology