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Arteriovenous Malformation of the Vein of Galen: Treatment in a Neonate

Arteriovenous Malformation of the Vein of Galen: Treatment in a Neonate Abstract • Heart failure in a 2-day-old infant was not readily explained by clinical examination. Cardiac catheterization suggested an intracranial arteriovenous (AV) fistula, and cerebral arteriography showed a malformation of the vein of Galen. The major feeding arteries were surgically obliterated. At age 27 months, the boy has normal mentation but moderate left hemiparesis. Review of the literature disclosed 39 other infants with AV malformations of the vein of Galen producing heart failure before age 3 months. Most of them were boys, and had cyanosis, a systolic murmur, cranial bruit, cardiomegaly, and right ventricular hypertrophy. Only three of the 13 who had surgery for their malformation survived. Removal of the malformation is difficult; obliteration of the nutrient vessels, using the operating microscope, is the currently accepted treatment. (Am J Dis Child 130:520-525, 1976) References 1. Pétranca C: Angiome artério-veineux de la veine de Galien et des artéres de l'hexagone de Willis chez l'enfant, thesis. Paris, 1952. 2. Clément R, Gerbeaux J, Combes-Hamelle A, et al: Aneurysmes artério-veineux de l'ampoule de Galien chez le nourrison . Presse Med 62:658-661, 1954. 3. Silverman BK, Breckx T, Craig J, et al: Congestive failure in the newborn caused by cerebral A-V fistula . Am J Dis Child 89:539-543, 1955. 4. Gold AP, Ransohoff J, Carter S: Vein of Galen malformation . Acta Neurol Scand 40( (suppl 11) ):1-31, 1964. 5. Montoya G, Dohn DF, Mercer RD: Arteriovenous malformation of the vein of Galen as a cause of heart failure and hydrocephalus in infants . Neurology 21:1054-1058, 1971.Crossref 6. Holden AM, Fyler DC, Shillito J Jr, et al: Congestive heart failure from intracranial arteriovenous fistula in infancy . Pediatrics 49:30-39, 1972. 7. Cronqvist S, Granholm L, Lundström N: Hydrocephalus and congestive heart failure caused by intracranial arteriovenous malformations in infants . J Neurosurg 36:249-254, 1972.Crossref 8. Fisher HC, Johnson ME: Congenital arteriovenous communication . Am Surg 23:112-125, 1957. 9. Pollock AQ, Laslett PA: Cerebral arteriovenous fistula producing cardiac failure in the newborn infant . J Pediatr 53:731-736, 1958.Crossref 10. Gagnon J, Boileau G: Anatomical study of an arteriovenous malformation drained by the system of Galen . J Neurosurg 17:75-80, 1960.Crossref 11. Glatt BS, Rowe RD: Cerebral arteriovenous fistula associated with congestive heart failure in the newborn: Report of two cases . Pediatrics 26:596-603, 1960. 12. Claireaux AE, Newman CGH: Arteriovenous aneurysm of the great vein of Galen with heart failure in the neonatal period . Arch Dis Child 35:605-612, 1960.Crossref 13. Hirano A, Solomon S: Arteriovenous aneurysm of the vein of Galen . Arch Neurol 3:589-593, 1960.Crossref 14. Levine OR, Jameson AG, Nelhaus G, et al: Cardiac complications of cerebral arteriovenous fistula in infancy . Pediatrics 30:563-575, 1962. 15. Gomez MR, Whitten CF, Nolke A, et al: Aneurysmal malformation of the great vein of Galen causing heart failure in early infancy: Report of five cases . Pediatrics 31:400-411, 1963. 16. Falcone DM, Friedman S, Peker H: Precordial murmurs in high cardiac output states: Differentiation from murmurs of congenital heart disease in infancy . J Pediatr 66:729-736, 1965.Crossref 17. Ford FR: Disease of the Nervous System in Infancy, Childhood and Adolescence . Springfield, Ill, Charles C Thomas Publisher, 1966, pp 871-872. 18. Sütterle H: Auswirkungen des arteriovenösen Aneurysmas der Vena Galeni . Arch Kinderheilkd 173:237-245, 1966. 19. Carroll CP, Jakoby RK: Neonatal congestive heart failure as the presenting symptom of cerebral arteriovenous malformation . J Neuro surg 25:159-163, 1966. 20. Brown BS, Alexander WJ: Radiologic aspects of arteriovenous aneurysm of the great vein of Galen . Ann Radiol 10:165-171, 1967. 21. Stern L, Ramos AD, Wiglesworth FW: Congestive heart failure secondary to cerebral arteriovenous aneurysm in the newborn infant . Am J Dis Child 115:581-587, 1968. 22. Noetzel H, Zorger B: Angiodysplasie der basalen Hirnarterien mit Varix der Vena magna Galeni . Z Kinderchir 5:156-166, 1967. 23. Mennicken U, Rau G: Herzinsuffizienz bei einem Neugeborenen mit kongenitaler intrakranieller arteriovenöser Fistel . Monatsschr Kinderheilkd 117:393-394, 1969. 24. Levy AM, Hanson JS, Tabakin BS: Congestive heart failure in the newborn infant in the absence of primary cardiac disease . Am J Cardiol 26:409-415, 1970.Crossref 25. Lagos JC, Riley HD Jr: Congenital intracranial vascular malformations in children . Arch Dis Child 46:285-290, 1971.Crossref 26. Sunderland CO, Morgan CL, Lees HM: Cerebral arteriovenous fistula producing temporary heart failure in a newborn infant . Clin Pediatr 10:309-311, 1971.Crossref 27. Boynton RC, Morgan BC: Cerebral arteriovenous fistula with possible hereditary telangiectasia . Am J Dis Child 125:99-101, 1973. 28. Stehbens WE, Sahgal KK, Nelson L, et al: Aneurysm of vein of Galen and diffuse meningeal angiectasia . Arch Pathol 95:333-335, 1973. 29. Hope R, Izukawa T: Congestive cardiac failure and intracranial arteriovenous communications in infants and children . Aust NZ J Med 3:598-605, 1973.Crossref 30. Norman MG, Becker LE: Cerebral damage in neonates resulting from arteriovenous malformation of the vein of Galen . J Neurol Neurosurg Psychiatry 37:252-258, 1974.Crossref 31. Long DM, Seljeskog EL, Chou SN, et al: Giant arteriovenous malformations of infancy and childhood . J Neurosurg 40:304-312, 1974.Crossref 32. Cunliffe PN: Cerebral arteriovenous aneurysm presenting with heart failure . Br Heart J 36:919-923, 1974.Crossref 33. Moore RY, Baumann RJ: Intracranial bruits in children . Dev Med Child Neurol 11:650-652, 1961.Crossref 34. Mace JW, Peters ER, Mathies AW Jr: Cranial bruits in purulent meningitis in childhood . N Engl J Med 278:1420-1422, 1968.Crossref 35. Lobo-Antunes J, Yahr MD, Hilal SK: Extrapyramidal dysfunction with cerebral arteriovenous malformations . J Neurol Neurosurg Psychiatry 37:259-268, 1974.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Arteriovenous Malformation of the Vein of Galen: Treatment in a Neonate

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1976.02120060066013
Publisher site
See Article on Publisher Site

Abstract

Abstract • Heart failure in a 2-day-old infant was not readily explained by clinical examination. Cardiac catheterization suggested an intracranial arteriovenous (AV) fistula, and cerebral arteriography showed a malformation of the vein of Galen. The major feeding arteries were surgically obliterated. At age 27 months, the boy has normal mentation but moderate left hemiparesis. Review of the literature disclosed 39 other infants with AV malformations of the vein of Galen producing heart failure before age 3 months. Most of them were boys, and had cyanosis, a systolic murmur, cranial bruit, cardiomegaly, and right ventricular hypertrophy. Only three of the 13 who had surgery for their malformation survived. Removal of the malformation is difficult; obliteration of the nutrient vessels, using the operating microscope, is the currently accepted treatment. (Am J Dis Child 130:520-525, 1976) References 1. Pétranca C: Angiome artério-veineux de la veine de Galien et des artéres de l'hexagone de Willis chez l'enfant, thesis. Paris, 1952. 2. Clément R, Gerbeaux J, Combes-Hamelle A, et al: Aneurysmes artério-veineux de l'ampoule de Galien chez le nourrison . Presse Med 62:658-661, 1954. 3. Silverman BK, Breckx T, Craig J, et al: Congestive failure in the newborn caused by cerebral A-V fistula . Am J Dis Child 89:539-543, 1955. 4. Gold AP, Ransohoff J, Carter S: Vein of Galen malformation . Acta Neurol Scand 40( (suppl 11) ):1-31, 1964. 5. Montoya G, Dohn DF, Mercer RD: Arteriovenous malformation of the vein of Galen as a cause of heart failure and hydrocephalus in infants . Neurology 21:1054-1058, 1971.Crossref 6. Holden AM, Fyler DC, Shillito J Jr, et al: Congestive heart failure from intracranial arteriovenous fistula in infancy . Pediatrics 49:30-39, 1972. 7. Cronqvist S, Granholm L, Lundström N: Hydrocephalus and congestive heart failure caused by intracranial arteriovenous malformations in infants . J Neurosurg 36:249-254, 1972.Crossref 8. Fisher HC, Johnson ME: Congenital arteriovenous communication . Am Surg 23:112-125, 1957. 9. Pollock AQ, Laslett PA: Cerebral arteriovenous fistula producing cardiac failure in the newborn infant . J Pediatr 53:731-736, 1958.Crossref 10. Gagnon J, Boileau G: Anatomical study of an arteriovenous malformation drained by the system of Galen . J Neurosurg 17:75-80, 1960.Crossref 11. Glatt BS, Rowe RD: Cerebral arteriovenous fistula associated with congestive heart failure in the newborn: Report of two cases . Pediatrics 26:596-603, 1960. 12. Claireaux AE, Newman CGH: Arteriovenous aneurysm of the great vein of Galen with heart failure in the neonatal period . Arch Dis Child 35:605-612, 1960.Crossref 13. Hirano A, Solomon S: Arteriovenous aneurysm of the vein of Galen . Arch Neurol 3:589-593, 1960.Crossref 14. Levine OR, Jameson AG, Nelhaus G, et al: Cardiac complications of cerebral arteriovenous fistula in infancy . Pediatrics 30:563-575, 1962. 15. Gomez MR, Whitten CF, Nolke A, et al: Aneurysmal malformation of the great vein of Galen causing heart failure in early infancy: Report of five cases . Pediatrics 31:400-411, 1963. 16. Falcone DM, Friedman S, Peker H: Precordial murmurs in high cardiac output states: Differentiation from murmurs of congenital heart disease in infancy . J Pediatr 66:729-736, 1965.Crossref 17. Ford FR: Disease of the Nervous System in Infancy, Childhood and Adolescence . Springfield, Ill, Charles C Thomas Publisher, 1966, pp 871-872. 18. Sütterle H: Auswirkungen des arteriovenösen Aneurysmas der Vena Galeni . Arch Kinderheilkd 173:237-245, 1966. 19. Carroll CP, Jakoby RK: Neonatal congestive heart failure as the presenting symptom of cerebral arteriovenous malformation . J Neuro surg 25:159-163, 1966. 20. Brown BS, Alexander WJ: Radiologic aspects of arteriovenous aneurysm of the great vein of Galen . Ann Radiol 10:165-171, 1967. 21. Stern L, Ramos AD, Wiglesworth FW: Congestive heart failure secondary to cerebral arteriovenous aneurysm in the newborn infant . Am J Dis Child 115:581-587, 1968. 22. Noetzel H, Zorger B: Angiodysplasie der basalen Hirnarterien mit Varix der Vena magna Galeni . Z Kinderchir 5:156-166, 1967. 23. Mennicken U, Rau G: Herzinsuffizienz bei einem Neugeborenen mit kongenitaler intrakranieller arteriovenöser Fistel . Monatsschr Kinderheilkd 117:393-394, 1969. 24. Levy AM, Hanson JS, Tabakin BS: Congestive heart failure in the newborn infant in the absence of primary cardiac disease . Am J Cardiol 26:409-415, 1970.Crossref 25. Lagos JC, Riley HD Jr: Congenital intracranial vascular malformations in children . Arch Dis Child 46:285-290, 1971.Crossref 26. Sunderland CO, Morgan CL, Lees HM: Cerebral arteriovenous fistula producing temporary heart failure in a newborn infant . Clin Pediatr 10:309-311, 1971.Crossref 27. Boynton RC, Morgan BC: Cerebral arteriovenous fistula with possible hereditary telangiectasia . Am J Dis Child 125:99-101, 1973. 28. Stehbens WE, Sahgal KK, Nelson L, et al: Aneurysm of vein of Galen and diffuse meningeal angiectasia . Arch Pathol 95:333-335, 1973. 29. Hope R, Izukawa T: Congestive cardiac failure and intracranial arteriovenous communications in infants and children . Aust NZ J Med 3:598-605, 1973.Crossref 30. Norman MG, Becker LE: Cerebral damage in neonates resulting from arteriovenous malformation of the vein of Galen . J Neurol Neurosurg Psychiatry 37:252-258, 1974.Crossref 31. Long DM, Seljeskog EL, Chou SN, et al: Giant arteriovenous malformations of infancy and childhood . J Neurosurg 40:304-312, 1974.Crossref 32. Cunliffe PN: Cerebral arteriovenous aneurysm presenting with heart failure . Br Heart J 36:919-923, 1974.Crossref 33. Moore RY, Baumann RJ: Intracranial bruits in children . Dev Med Child Neurol 11:650-652, 1961.Crossref 34. Mace JW, Peters ER, Mathies AW Jr: Cranial bruits in purulent meningitis in childhood . N Engl J Med 278:1420-1422, 1968.Crossref 35. Lobo-Antunes J, Yahr MD, Hilal SK: Extrapyramidal dysfunction with cerebral arteriovenous malformations . J Neurol Neurosurg Psychiatry 37:259-268, 1974.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: May 1, 1976

References