Alvarez H, Garcia Monaco R, Rodesch G, Sachet M, Krings T, Lasjaunias Pierre
Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Bicêtre 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, Paris, France.
Neuroimaging Clin N Am. 2007 May;17(2):189-206. doi: 10.1016/j.nic.2007.02.005.
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. Heart failure and hydrocephalus respond favorably to embolization. Cerebrospinal fluid ventricular shunting, if needed, should be performed after the embolization. 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.
不同类型的畸形都存在大脑大静脉扩张,但其中只有一种是真正的大脑大静脉动脉瘤样畸形(VGAM)。最佳治疗时机是在4至5个月大时[已修正],因为这能让患儿成长和成熟。心力衰竭和脑积水对栓塞治疗反应良好。如有必要,应在栓塞治疗后进行脑脊液脑室分流术。经静脉入路的发病率和死亡率显著升高,很少采用。VGAM的解剖学治愈并非治疗的主要目标;最终目标是控制畸形,使大脑能够正常成熟和发育。