Document Detail

Congestive heart failure secondary to cerebral arterio-venous fistula.
MedLine Citation:
PMID:  3308085     Owner:  NLM     Status:  MEDLINE    
Arteriovenous fistula is a relatively rare cause of severe congestive heart failure in the newborn. An intracranial arteriovenous malformation associated with an aneurysm of the great vein of Galen is the most frequent of such malformations and, although well known, it remains a difficult diagnosis in the neonate because the clinical picture first presents with findings suggesting cardiac disease. The newborn with a vein of Galen aneurysm has volume and pressure overload on his myocardium; cyanosis is often present due to persistent fetal circulation; peripheral pulses are generally decreased in amplitude except in those arteries near the fistula where they are bounding, as an expression of a hyperdynamic status. A continuous murmur may be heard over the scalp, but this highly suggestive sign is often not present. The majority of newborns with intracranial arteriovenous fistula die very soon. Unfortunately, most of these infants are at first considered to have congenital heart disease and are, therefore, subjected to cardiac catheterization and angiography, with their well-known risks, before a correct diagnosis is made. Cross-sectional echocardiography, by demonstrating normal intracardiac anatomy, eliminates the need for an invasive investigation in a very sick neonate. Ultrasonography of the head will then provide a rapid and accurate demonstration of the aneurysm of vein of Galen. Cerebral angiography will complete the diagnosis in those cases in which a neurosurgical intervention is contemplated.
P A Pellegrino; O Milanesi; O S Saia; C Carollo
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  3     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  1987  
Date Detail:
Created Date:  1987-11-19     Completed Date:  1987-11-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  141-4     Citation Subset:  IM    
Department of Pediatrics, University of Padua School of Medicine, Italy.
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MeSH Terms
Heart Failure / etiology*
Infant, Newborn
Intracranial Arteriovenous Malformations / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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