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Review on the current treatment status of vein of Galen malformations and future directions in research and treatment
Published in Expert Review of Medical Devices, 2021
Panagiotis Primikiris, Georgios Hadjigeorgiou, Maria Tsamopoulou, Alessandra Biondi, Christina Iosif
In utero diagnosis and evaluation is very important and should nowadays include MRI imaging and to search for pseudo-feeders. The latter has been proven to be an important tool also after birth, not only in evaluating the brain parenchyma and ventricles and guiding therapeutics and timing of interventions but also in further elucidating angioarchitecture. Recent data have shown that the internal cerebral veins may communicate with the venous sac in some cases of VOGM [52]. In such cases occlusion of the VOGM venous sac can obstruct ICV drainage, unless there is a concurrent alternate drainage pathway. The detailed analysis of the angioarchitecture, using MRI protocols that include SWI sequences and 3DTOF, as well as CM or ASL MRA-MRV, may reduce procedure-related morbidity and mortality and enhance treatment planning, by providing further angioarchitectural data.