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Journal of neurosurgery · Jan 2014
Case ReportsDefinitive treatment of vein of Galen aneurysmal malformation with stereotactic radiosurgery.
- William J Triffo, J Daniel Bourland, Daniel E Couture, Kevin P McMullen, Stephen B Tatter, and Padraig P Morris.
- Departments of Radiology.
- J. Neurosurg.. 2014 Jan 1;120(1):120-5.
AbstractVein of Galen aneurysmal malformations (VGAMs) are uncommon congenital malformations arising from fistulous communication with the median vein of the prosencephalon, a primitive precursor of midline cerebral venous structures. Angiographic embolization is the primary modality for treatment given historically poor microsurgical outcomes. Only a few reports of treatment by Gamma Knife radiosurgery (GKRS) exist in the literature, and the results are variable. The authors present 2 cases of VGAM in which GKRS provided definitive treatment with good outcome: one case involving antenatal presentation of a high-output, mural-type VGAM with complex clinical course refractory to multiple embolic procedures, and the other a choroidal-type VGAM presenting with hemorrhage in an adult and without a feasible embolic approach. With discussion of these cases and review of the literature, the authors advocate inclusion of GKRS as a therapeutic option for treatment of these complex lesions.
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