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Author Rao, V. R. K. ♦ Ravimandalam, K. ♦ Gupta, A. K. ♦ Joseph, S. ♦ Unni, M. ♦ Rao, A. S.
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Journal of Neuroradiology
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Domain (in MeSH) Cardiovascular Diseases ♦ Diseases ♦ Diagnosis ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment
Subject Keyword Radiology
Abstract Angioarchitecture of the aneurysmal malformation of the vein of Galen in 9 patients is analysed. An arterial maze arborised directly into the vein of Galen in 6 patients. Direct fistulous communication from one or two pedicles was noted in three children. Unilateral choroidal arterial contribution via an eccentric cul-de-sac in two infants suggested embryonic involvement of the ipsilateral internal cerebral vein along with the median prosencephalic vein of Markowski. Unusually, a sylvian branch of the middle cerebral artery drained directly into the basal vein of Rosenthal which in turn communicated to the aneurysm of vein of Galen in another patient. Two adult patients had curvilinear rim calcification of the venous sac with rapid circulation. All but two showed venous sinus anomalies. Two children had prior shunt surgery at the referring hospitals. The pathophysiology of hydrocephalus and the possible consequences of shunt, question the need for CSF diversion as a routine in these patients. Percutaneous trans-arterial embolotherapy, in five patients achieved complete obliteration of the malformation in four patients and partial reduction of flow in another. While transvenous/trans-torcular approach is reserved for selected patients and direct surgery carries high morbidity, this report emphasises the efficacy of trans-arterial embolotherapy.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Volume Number 21
Issue Number 3
Page Count 10
Starting Page 213
Ending Page 222