Vein of Galen Malformation Treatment

Hydrocephalus associated with Vein of Galen Malformation is obstructive, due to varix. Although admonitions about shunting were common due to fear of precipitating a hemorrhage when hydrocephalus is present the patient needs a shunt.

Pediatric patients are often in poor medical condition, limiting the efficacy of operative treatment. Treatment options for these include embolization of the main feeding arteries. The prognosis is poor. Those presenting with hydrocephalus from aqueductal obstruction often do so at the end of the first year of life. Neurosurgical excision may be considered here, and the prognosis is better.

Repeated embolization while monitoring the venous drainage is employed.

The AVM is treated by the same methods as other AVMs (embolization, resection, or radiosurgery).

There have been many multidisciplinary approaches to the treatment of vein of Galen malformations.

These lesions can present with high-output congestive heart failure, seizures, failure to thrive, hydrocephalus, and brain hemorrhage. High surgical morbidity and mortality, exceeding 90% in some series, has led to the development of endovascular techniques that more safely and effectively treat these lesions ^{1) 2) 3) 4)}.