Neuroimaging clinics of North America
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Recent advances in pediatric neurosurgery have drastically improved the outcome in infants and children afflicted with surgical lesions of the central nervous system (CNS). Because most of these techniques were first applied to adults, the physiologic and developmental differences that are inherent in pediatric patients present challenges to neurosurgeons and anesthesiologists alike. The aim of this paper is to highlight these age-dependent approaches to the pediatric neurosurgical patient.
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Different types of malformations share a dilated vein of Galen, but only one of them is a true vein of Galen aneurysmal malformation (VGAM). The optimal window of opportunity for treatment is between 4 and 5 years of months [corrected], because this allows the child to grow and mature. ⋯ The transvenous approach carries significantly elevated morbidity and mortality and is rarely indicated. Anatomic cure of the VGAM is not the main goal of treatment; the ultimate goal is control of the malformation to allow the brain to mature and develop normally.