Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 17, Issue 8, Pages 405-410Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-2000-13456
Keywords
arteriovenous malformation; Vein of Galen; persistent pulmonary hypertension of the newborn; endovascular embolization
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Arteriovenous malformations of the Vein of Galen continue to present diagnostic and therapeutic challenges in the neonatal period. Approximately 40-50% of all mal formations of the Vein of Galen present in the neonatal period, usual ly with congestive heart failure. These neonates represent the most severe cases and are also the most difficult to manage. We report a case of a neonate with a Vein of Galen Malformation who presented with cyanosis, a cardiac murmur, and severe persistent pulmonary hypertension of the newborn. Cardiac failure developed later in the patient's course. The degree of pulmonary hypertension on echocardiography was used to time endovascular embolization of the Vein of Galen Malformation. Following embolization, his pulmonary hypertension subsided dramatically. We speculate that pulmonary hypertension associated with Vein of Galen Malformations has been underestimated in the morbidity and demise of these neonates, and should be more aggressively monitored and treated.
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