Surgical obliteration for vein of Galen malformation: a case report

J L Moriarity, G K Steinberg
Surgical Neurology 1995, 44 (4): 365-9; discussion 369-70

BACKGROUND: Vein of Galen aneurysm is a relatively rare vascular malformation, often resulting in high morbidity or mortality. Outcome is particularly poor in the neonatal population.

METHODS: We report staged surgical treatment of a vein of Galen aneurysm in a neonate who presented in congestive heart failure.

RESULTS: Cerebral angiography 6 months following staged surgical treatment revealed complete obliteration of the aneurysm. The patient tolerated surgery well, and at 6 years of age is free of neurologic or cardiovascular impairment.

CONCLUSIONS: While the endovascular approach is the procedure of first choice, aggressive medical management followed by staged surgical clipping of aneurysm feeders produced excellent results in this case of neonatal vein of Galen aneurysm. Staged surgical obliteration of arterial feeders should be considered as a therapy when endovascular methods are unsuccessful in safely curing these difficult vascular lesions.

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