Vein of Galen malformation in a neonate: A case report and review of endovascular management

Table 1 Classification of vein of galen aneurysmal malformations

Classification system
Litvak
Category A	Aneurysms of the great vein of Galen
Category B	Racemorse conglomeration of blood vessels in the cerebral structures
Category C	Transitional types of midline AV shunts
Lasjaunias
Type I	Choroidal type
Type II	Mural type
Yasargil
Type I	Pure AVF between leptomeningeal arteries and feeders from P3, segments of posterior cerebral arteries and vein of Galen
Type II	Feeders from the thalamo-perforating vessels and from P1 and P2 segments of the posterior cerebral arteries
Type III	Mixture of type I and II
Type IV
IV A	Aneurysmal dilation of the vein of Galen resulting from shunting from an adjacent thalamic AVM
IV B	Similar to type IV A with the AVM being mesencephalic instead of thalamic
IV C	Thalamomesencephalic or mesodiencephalic plexiform malformation along with an adjacent and separate cisternal AVF to the vein of Galen
Secondary enlargement of vein of Galen
Vein of Galen dilation	Malformations that drain pial or dural shunts into the true vein of Galen or its tributary associated with the dilation of the vein of Galen
Vein of Galen varix	Dilation of the vein of Galen in the absence of AV shunt

Table 2 Clinical details and outcome of 47 neonatal embolizations

Diagnosed	Gestational age (wk)	Birth weight (g)	Symptoms	Total sessions	Outcome	Ref.
Antenatal (31 wk)	N/A	N/A	CCF	Multiple	Normal	Mitchell et al[19] 2001
Postnatal	N/A	N/A	CCF	Multiple	Normal
Postnatal	N/A	N/A	CCF	1	Death (2 d)
Postnatal	N/A	N/A	CCF	Multiple	Normal
Antenatal (36 wk)	Full term	N/A	CCF	3	Death (24 d)	Frawley et al[17] 2002
Postnatal	Full term	N/A	CCF	3	Normal
Postnatal	Full term	N/A	CCF	1	Death (2 d)
Postnatal	Full term	N/A	CCF	4	Psychomotor delay
Postnatal	Full term	N/A	CCF	4	Normal
Postnatal	Full term	N/A	CCF	1	Normal
Antenatal (38 wk)	Full term	N/A	CCF	3	Normal
Antenatal (32 wk)	Full term	N/A	CCF	4	Death (39 d)
Postnatal	36	N/A	CCF	1	Death (24 h)	Jones et al[20] 2002
Postnatal	Full term	N/A	CCF	Multiple	Normal
Antenatal (28 wk)	N/A	N/A	CCF	1	Death (29 h)	Maheshwari et al[23] 2003
Postnatal	Full term	3400	CCF	1	Death (7d)	Mathew et al[21] 2013
N/A	Full term	N/A	CCF	2	Normal	McSweeney et al[22] 2010
N/A	Full term	N/A	CCF	1	Normal
N/A	Full term	N/A	CCF	1	Normal
N/A	Full term	N/A	CCF	4	Psychomotor delay
N/A	Full term	N/A	CCF	3	Psychomotor delay
N/A	Full term	N/A	CCF	5	Psychomotor delay
N/A	Full term	N/A	CCF	1	Death
N/A	Full term	N/A	CCF	1	Death
Antenatal (35 wk)	Full term	3290	CCF	1	Normal	Karadeniz et al[16] 2011
Postnatal	N/A	N/A	CCF	2	Normal	Meila et al[18] 2012
Antenatal	N/A	N/A	CCF	4	Normal
Postnatal	N/A	N/A	CCF	6	Death (2 yr)
Postnatal	N/A	N/A	CCF	2	Psychomotor delay
Postnatal	N/A	N/A	CCF	6	Psychomotor delay
Antenatal	N/A	N/A	CCF	3	Normal
Postnatal	N/A	N/A	CCF	4	Normal
Antenatal	N/A	N/A	CCF	3	Psychomotor delay
Postnatal	36	2897	CCF	5	Normal	Berenstein et al[5] 2012
Postnatal	34	1810	CCF	1	Death
Antenatal	Full term	4165	CCF	2	Normal
Antenatal	36	3409	CCF	4	Normal
Postnatal	Full term	3400	CCF	6	Normal
Postnatal	Full term	2930	CCF	6	Hemiparesis
Antenatal	Full term	2386	CCF	2	Normal
Antenatal	Full term	4204	CCF	6	Psychomotor delay
Antenatal	36	2825	CCF	3	Psychomotor delay
Antenatal (36 wk)	Full term	2675	CCF	5	Normal	The present report