Cognitive and functional status after vein of Galen aneurysmal malformation endovascular occlusion

Table 1 Patient characteristics

Patient	Age1	Gender	Presenting symptoms	Initial diagnostic imaging
1	Birth/5 d	Male	Congestive heart failure, cranial bruit	Non-contrast head computed tomography
2	5 mo/8 mo	Male	Macrocephalus, cranial bruit	Magnetic resonance imaging brain +/- contrast
3	Prenatal/5 d	Female	Congestive heart failure	Prenatal ultrasound
4	24 yr/27 yr	Male	Face pain, dementia	Magnetic resonance imaging brain +/- contrast
5	21 mo/32 yr	Female	Macrocephalus, cranial bruit	Skull X-ray

¹At presentation/ at stage 1 embolization.

Table 2 Galen aneurysmal malformations endovascular occlusion

Patient	Angio-architecture	n1	Endovascular access	Extent of occlusion	Clinical endpoint	Embolic agents	Periprocedural complications
1	Choroidal	3	Transarterial and transvenous	Complete	Normalization of cardiac function	Fibered and non-fibered platinum coils, N-butyl cyanoacrylate	Left parietal infarct post stage 2 embolization, consumptive coagulopathy and IVH post stage 3 embolization
2	Mural	3	Transarterial and transvenous	Complete	Normalization of head circumference	Fibered and non-fibered platinum coils, NBCA, Berenstein liquid coils	None
3	Mural	1	Transarterial and transvenous	Subtotal	Normalization of cardiac function	Fibered and non-fibered platinum coils	Small germinal matrix hemorrhage 21 d post embolization
4	Mural	3	Transarterial and transvenous	Complete	Resolution of vascular dementia and hemifacial pain	Fibered and non-fibered platinum coils, NBCA	None
5	Mural	3	Transarterial and transvenous	Near complete	Resolution of vascular dementia, seizures, and headaches	Fibered and non-fibered platinum coils, NBCA, hydrogel coils, polyvinyl alcohol, ethanol	None

¹At presentation/ at stage 1 embolization. IVH: Intraventricular hemorrhage.

Table 3 Treatment outcomes

Patient	Follow-up1	Clinical status	Bicêtre outcome score	Barthel index score	NRS-R executive/cognitive item difficulties
1	97.2	CHF resolved, neurologically intact	5	100	None
2	62.6	Neurologically intact	5	100	None
3	30.9	CHF resolved, neurologically intact, meeting all developmental milestones	5	NA	NA
4	2	Neurologically intact, facial pain relief	5	100	None
5	74.8	Neurological deficits including: abducens nerve palsy, left sided hemiparesis (ambulates independently with leg brace), and decreased visual acuity	2	95	Mild disorientation, memory, self-appraisal, planning, and decreased initiative/motivation

¹Months post Galen aneurysmal malformations embolization. NRS-R: Neurobehavioral Rating Scale-Revised; CHF: Congestive heart failure; NA: Not avaliable.