aneurisma de la vena de galenoaneurisma de la vena de galeno

jaime diegopérez ramírezjefe neurocirugia

hospital de pediatría del centro medico nacional siglo xxi

Instituto Mexicano del Seguro Social

jaime diegopérez ramírezjefe neurocirugia

hospital de pediatría del centro medico nacional siglo xxi

Instituto Mexicano del Seguro Social

• sinonimia:

• aneurisma varicoso

• aneurisma de la ampolla

• malformación

• fístula arteriovenosa

• Even when the disease has been recognized as a congenital condition, was first described in an adult of 49 years by Steinhel in 1895

• Clinically 3 different types:

• Newborn presentation ( high mortality)

• Infants (prominent veins and hydrocephalus)

• Adolescence and adults

Clinical data

• Newborn

• Macrocephaly

• Prominent frontal vein

• Holosystolic trill

• Cardiac failure

Clinical data

• Infant

• Hydrocephaly

• Mild intelectual deficit

• Epilepsy

• Epilepsy

• Mild neurocognitive deficit

• headache?

• Espontaneous hemorrage?

Clasification

• Thalamic AVM adyacent to

• AV Fistulae ChoroidalChoroidal

MuralMural

choroidal

mural

Clinical progression

Prognostic Scale

Less than 8: poor prognosis, no treatment9 to 12 more than 50% of survivors if treated acutely

Above 12 good prognosis, programed intervention

Diagnostic studies

• Ultasound prenatal and neonatal

• IRM with angiography

• Angiography (interventional)

treatment

• Until 20th century by 40’s it was no treatment but in 1945 it was the first AVC (abrir, ver y cerrar) surgery

• In 60’s was first described the 3 different prognostic groups.

• Surgery era between 70’ and 80’ the surgical era

• Latest 80’ and early 90’s endovascular embolization

Surgery

• There’s no efective surgical treatment

• clipping feeders

• Shunting (not recomended)

Embolization

Embolization

centro medico nacionalsiglo xxi

• 6 casos

• 4 neonatal presentation

• 3 die, 1 lost in following