Endovascular Management of Vein of Galen Malformation

Vein of Galen aneurysmal malformation (VGAMs) has"nhigh morbidity and mortality rates especially in the"npediatric population. Whereas, in the past, mortality"nrates were nearly 100%, recent developments in"nendovascular embolization have improved the"nprognosis. Vein of Galen malformations have proven"nto be very difficult to treat by standard surgical"nprocedures. However, endovascular embolization can"nprovide significant improvements to this condition."nSuccessful treatment involves many stages of"nendovascular embolization over a long period of time."nEmbolization involves injection of a glue-like material"nthrough a catheter placed near the malformation"nin the brain. Access to the lesion can be gained via"ntransarterial or transvenous routes which are mostly"nvia the transarterial approach. Often a patient will"nrequire more than one embolization. Some patients"nmay be cured by partial embolization. Endovascular"nembolization has considerably improved outcomes"nin patients with VGAM. More recently, with"nthe continued development and improvement of"nendovascular techniques, many patients are found to"nbe neurologically normal on follow-up and mortality"nrates have dropped substantially when compared "nwith microsurgical treatment. In most experiences,"nendovascular treatment always seems to be the best"nprimary treatment in VGAMs. It is now possible"nthat lots of patients grow up completely normal after"ntreatment. The risk of treatment varies but may be as"nhigh as 10% for permanent disabling stroke or death.