Anesthetic Management of an Intracranial Arteriovenous Malformation in Infancy

Hood, Judith B.; Wallace, Charles T.; Mahaffey, John E.

doi:10.1213/00000539-197703000-00015

Cited by 3 publications

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“…Open cardiac surgery in a patient with an untreated VGAM has not been previously reported although historically CPB with profound hypothermia or even total circulatory arrest was one of the novel strategies utilized as a potential means of reducing blood loss in the neurosurgical management of a vein of Galen malformation (12,13).…”

Section: Discussionmentioning

confidence: 99%

Repair of sinus venosus defect in a patient with untreated vein of Galen aneurysmal malformation

Ahmad¹,

Walker²,

Brew

2008

Pediatric Anesthesia

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The vein of Galen aneurysmal malformation (VGAM) is a rare cerebral arteriovenous shunt, which may be associated with a congenital cardiac defect. Embolisation of the VGAM may be undertaken in the neonatal period if necessary, but is safer in infancy. Recent advances in neuroradiology have changed the prognosis for this group with many patients achieving survival with normal development. This case report describes a patient with a sinus venosus defect (SVD) and a VGAM and considers both the optimal timing of treatment of the two malformations and the conduct of anaesthesia for open repair of the SVD in the presence of an untreated VGAM.

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Section: Discussionmentioning

confidence: 99%

Repair of sinus venosus defect in a patient with untreated vein of Galen aneurysmal malformation

Ahmad¹,

Walker²,

Brew

2008

Pediatric Anesthesia

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Anaesthetic management of arteriovenous malformations of the vein of galen

McLeod

Creighton

Humphreys

1982

Can. Anaesth. Soc. J.

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Arteriovenous malformations of the vein of Galen, though rare, are associated with a significant mortality. The anaesthetic management of patients with this defect during surgery may be complicated by massive blood loss and congestive heart failure. Four patients under 18 months of age underwent craniotomies for arteriovenous malformations of the vein of Galen. Since two required a second eraniotomy for ligation of residual feeding vessels, there were six procedures in the four patients. Average blood loss per procedure was estimated at 126 per cent of blood volume. One patient died during operation and one had an intra-operative cardiac arrest. Both of these patients had associated cardiac failure. In the presence of a compromised myocardium, sudden blood loss or attempts at induced hypotension may result in inadequate diastolic perfusion of the heart and precipitate cardiac arrest. Consequently, these patients should be maintained in a euvolaemic state with transfusion and attempts at controlled hypotension should be avoided.

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Cerebral arteriovenous malformations in children

1994

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Le traitement neurochirurgical des malformations c~r(brales art~riaveineuses (MAV) repr$sente pour l'anesth$sie un d~fi majeur. Les grosses MAV sont rares chez l'enfant. Seulement 18% deviennent symptomatiques at,ant l'~ge de 15 ans. D'aprbs notre experience de 1982 h 1992, les premieres manifestations sont variables: h~morragie (50%), convulsions et hydroc~phalie (36%) ou d$faillance cardiaque globale (18%

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Anesthetic Management of an Intracranial Arteriovenous Malformation in Infancy

Cited by 3 publications

References 0 publications

Repair of sinus venosus defect in a patient with untreated vein of Galen aneurysmal malformation

Repair of sinus venosus defect in a patient with untreated vein of Galen aneurysmal malformation

Anaesthetic management of arteriovenous malformations of the vein of galen

Cerebral arteriovenous malformations in children

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