Document Detail


Serial ultrasonographic evaluation of neonatal vein of Galen malformations to assess the efficacy of interventional neuroradiological procedures.
MedLine Citation:
PMID:  2234356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Two-dimensional echocardiography complemented with color-flow imaging and pulsed Doppler ultrasound was used to evaluate one fetus and five neonates with a vein of Galen malformation who had severe high-output congestive heart failure and cranial bruits at birth. Intracranial blood flow through the vein of Galen malformations, cardiac status, and direction of aortic blood flow were assessed before and after staged interventional neuroradiological treatment with transarterial and transvenous embolization procedures. Color-flow imaging in each infant displayed the major vascular anatomy including feeding vessels and the patterns of filling of the vein of Galen malformations. Pulsed Doppler ultrasound performed on the descending aorta above the diaphragm showed the degree of diastolic flow reversal indicative of runoff into the vein of Galen malformations. A reduction in blood flow through the vein of Galen malformation was seen on color-flow imaging in four patients treated successfully by embolic procedures. The ratio of diastolic retrograde flow velocity in the descending aorta to systolic antegrade velocity decreased from 0.51 +/- 0.15 (mean +/- standard deviation) to 0.15 +/- 0.20 (P less than 0.05). Color-flow imaging and pulsed Doppler ultrasonography provided anatomical and pathophysiological information regarding cardiac hemodynamics and intracranial blood flow; with the patient's clinical status, these methods provided a reliable, noninvasive means to evaluate the effectiveness of therapy and the need for further treatment in neonates with vein of Galen malformations.
Authors:
S F Ciricillo; K G Schmidt; N H Silverman; G B Hieshima; R T Higashida; V V Halbach; M S Edwards
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  27     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-12-06     Completed Date:  1990-12-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  544-8     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, School of Medicine, University of California, San Francisco.
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MeSH Terms
Descriptor/Qualifier:
Cerebral Veins / abnormalities*,  ultrasonography
Embolization, Therapeutic
Heart Failure / etiology,  physiopathology,  therapy
Humans
Infant, Newborn
Postoperative Complications / mortality
Regional Blood Flow

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


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