Pseudofeeders on fetal magnetic resonance imaging predict outcome in vein of <scp>G</scp>alen malformations

Saliou, Guillaume; Vraka, Irène; Teglas, Jean-Paul; Sénat, Marie-Victoire; Durand, Philippe; Colmant, C.; Ozanne, Augustin; Martinovic, Jéléna; Tissiere, Pierre; Adamsbaum, C.

doi:10.1002/ana.24873

Cited by 27 publications

(46 citation statements)

References 23 publications

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“…Encephalomalacia was defined as a loss of brain parenchymal thickness combined with laminar necrosis. 13 According to the MRI results, we reviewed all MR images and classified them as follows: (1) unilobar: the encephalomalacia on MR images was located in a single lobe; (2) multilobar: the encephalomalacia on MR images involved two or more lobes but was limited to one hemisphere; and (3) bilateral: the encephalomalacia on MR images involved both hemispheres. The regions of the responsible lesion were delineated using the picture archiving and communication system of Hinacom Software and Technology (http://www.hinacom.com/EN/ Index).…”

Section: Mri Resultsmentioning

confidence: 99%

“…All magnetic resonance (MR) images were viewed by two neuroradiologists, and the findings were recorded. Encephalomalacia was defined as a loss of brain parenchymal thickness combined with laminar necrosis . According to the MRI results, we reviewed all MR images and classified them as follows: (1) unilobar: the encephalomalacia on MR images was located in a single lobe; (2) multilobar: the encephalomalacia on MR images involved two or more lobes but was limited to one hemisphere; and (3) bilateral: the encephalomalacia on MR images involved both hemispheres.…”

Section: Methodsmentioning

confidence: 99%

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Surgical outcomes and prognostic factors of drug‐resistant epilepsy secondary to encephalomalacia

Zhai

Guan

et al. 2019

Epilepsia

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Summary Objective To evaluate long‐term outcomes and prognostic factors in patients who underwent surgical resection for drug‐resistant epilepsy secondary to encephalomalacia. Methods A total of 143 patients with drug‐resistant epilepsy who underwent surgical resection with a follow‐up of at least 5 years were included. Seizure outcomes were evaluated based on the International League Against Epilepsy classification. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of seizure outcomes. Results Three months after surgery, 102 of 143 (71.3%) patients had achieved favorable seizure outcomes. Five years after surgery, 107 of 143 (74.8%) patients had achieved favorable seizure outcomes. Changes in the postoperative seizure status were observed in 22 of 143 (15.4%) patients during follow‐up, but the difference in the seizure‐free rate between 3 months and 5 years after surgery was not significant. Univariate and multivariate analyses revealed that only a monthly seizure frequency of >30 seizures (odds ratio = 3.42, 95% confidence interval = 1.19‐9.76) and bilateral ictal onset rhythms (odds ratio = 4.46, 95% confidence interval = 1.61‐12.39) were independent predictors of unfavorable seizure outcomes. Significance Surgical resection is an effective treatment for patients with drug‐resistant epilepsy secondary to encephalomalacia. Knowledge of the predictors of seizure outcomes may help during preoperative counseling and selection of optimal candidates for epilepsy surgery among patients with drug‐resistant epilepsy secondary to encephalomalacia.

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Section: Mri Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Surgical outcomes and prognostic factors of drug‐resistant epilepsy secondary to encephalomalacia

Zhai

Guan

et al. 2019

Epilepsia

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show abstract

“…Brain perfusion was evaluated by calculating the time taken in seconds for contrast to travel from the internal carotid artery to an M3 branch of the middle cerebral artery that was not supplying the shunt, in seconds. 7 Finally, VGM arteriovenous shunt patency on the most recent angiogram was evaluated.…”

Section: Methodsmentioning

confidence: 99%

Cross‐sectional study of a United Kingdom cohort of neonatal vein of galen malformation

Lecce

Robertson

Rennie

et al. 2018

Annals of Neurology

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ObjectiveDescribe the course and outcomes in a UK national cohort of neonates with vein of Galen malformation identified before 28 days of life.MethodsNeonates with angiographically confirmed vein of Galen malformation presenting to 1 of 2 UK treatment centers (2006–2016) were included; those surviving were invited to participate in neurocognitive assessment. Results in each domain were dichotomized into “good” and “poor” categories. Cross‐sectional and angiographic brain imaging studies were systematically interrogated. Logistic regression was used to explore potential outcome predictors.ResultsOf 85 children with neonatal vein of Galen malformation, 51 had survived. Thirty‐four participated in neurocognitive assessment. Outcomes were approximately evenly split between “good” and “poor” categories across all domains, namely, neurological status, general cognition, neuromotor skills, adaptive behavior, and emotional and behavioral development. Important predictors of poor cognitive outcome were initial Bicêtre score ≤ 12 and presence of brain injury, specifically white matter injury, on initial imaging; in multivariate analysis, only Bicêtre score ≤ 12 remained significant.InterpretationDespite modern supportive and endovascular treatment, more than one‐third of unselected newborns with vein of Galen malformation did not survive. Outcome was good in around half of survivors. The importance of white matter injury suggests that abnormalities of venous as well as arterial circulation are important in the pathophysiology of brain injury. Ann Neurol 2018;84:547–555

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“…Such enlarged arteries have been described previously as an indirect sign of severe vascular steal on postnatal MRI 3 . MCA pseudofeeders identified on prenatal MRI have been shown to be predictive of cardiac failure and encephalomalacia at birth and are therefore a risk factor for further brain damage at birth 2 .…”

Section: Figurementioning

confidence: 74%

Pseudofeeders: sonographic sign of poor prognosis in fetus with vein of Galen malformation

Bouchghoul

Adamsbaum

Maurey

et al. 2020

Ultrasound in Obstet & Gyne

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Pseudofeeders on fetal magnetic resonance imaging predict outcome in vein of Galen malformations

Abstract: MCA pseudofeeders are the result of impaired cerebral blood flow, and are thus a risk factor for further brain melting at birth. Their presence can be used for informing parents and as an aid in management decisions. Ann Neurol 2017;81:278-286.

Cited by 27 publications

References 23 publications

Surgical outcomes and prognostic factors of drug‐resistant epilepsy secondary to encephalomalacia

Surgical outcomes and prognostic factors of drug‐resistant epilepsy secondary to encephalomalacia

Cross‐sectional study of a United Kingdom cohort of neonatal vein of galen malformation

Pseudofeeders: sonographic sign of poor prognosis in fetus with vein of Galen malformation

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