0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Images in Neurology |

Vein of Galen Aneurysmal Malformation Treated With Onyx

Panagiotis Papanagiotou, MD; Tilman Rohrer, MD; Iris Q. Grunwald, MD; Maria Politi, MD; Ludwig Gortner, MD; Wolfgang Reith, MD
Arch Neurol. 2009;66(7):906-907. doi:10.1001/archneurol.2009.99.
Text Size: A A A
Published online

Extract

A 4-month-old infant was referred to the pediatrics neurology clinic with macrocephaly. Her neurological status was normal. Sonography, magnetic resonance imaging (MRI) and angiography revealed a large vein of Galen aneurysmal malformation (VGAM) (Figure 1). The patient was treated endovascularly, using ethylene-vinyl alcohol copolymer (Onyx) as an embolic agent. Occlusion of the feeding arteries was complete, and there was no remaining flow into the VGAM (Figure 2). Follow-up MRI after 1 year showed that hydrocephalus persisted, whereas the VGAM had shrunk (Figure 2). The patient had development delay and seizures.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure 2.

A, Postinterventional angiogram in frontal projection shows no remaining flow in the vein of Galen aneurysmal malformation (VGAM). Sagittal T2-weighted image 2 weeks after treatment shows no flow in the lesion. The VGAM appears hyperintense and homogenous hypointense in correspondence to building thrombus. B, Displacement of the brainstem and ventricles persists. T2-weighted magnetic resonance images 1 year after treatment show that the VGAM has shrunk. The borders of the aneurysm appear hypointense owing to collection of hemosiderin. The lesion no longer has a pressure effect. C and D, Note the subependymal atrophy.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 1.

A, Doppler sonography depicts 2 arterial feeders (arrows) and circular blood flow within the cyst, which demonstrates the vascular nature of the lesion. T2-weighted cranial magnetic resonance imaging in sagittal and transversal views show a vein of Galen aneurysmal malformation. B and C, Downward displacement of the brainstem and distortion of the ventricles with obstructive hydrocephalus. Digital subtraction angiography, frontal projection, and after-vertebral injection demonstrate a high-flow arterial feeder originating from the left posterior artery. The dome of the aneurysm is filled with contrast agent. D, Note the striking displacement of the arteries due to the lesion.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

99 Views
2 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();