Original Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Mar 28, 2012; 4(3): 83-89
Published online Mar 28, 2012. doi: 10.4329/wjr.v4.i3.83
Cognitive and functional status after vein of Galen aneurysmal malformation endovascular occlusion
Jason A Ellis, Lauren Orr, Paul C McCormick II, Richard CE Anderson, Neil A Feldstein, Philip M Meyers
Jason A Ellis, Lauren Orr, Paul C McCormick II, Richard CE Anderson, Neil A Feldstein, Philip M Meyers, Department of Neurological Surgery, Columbia University Medical Center, NY 10032, United States
Philip M Meyers, Department of Radiology, Columbia University Medical Center, NY 10032, United States
Author contributions: Ellis JA acquired data, provided analysis and interpretation of the data, and drafted this article; Orr L acquired data and drafted this article; McCormick II PC acquired data and drafted this article; Anderson RCE critically revised this article; Feldstein NA critically revised this article; Meyers PM critically revised this article and approved the final version for submission.
Correspondence to: Jason A Ellis, MD, Department of Neurological Surgery, Neurological Institute of New York, Columbia University Medical Center, 710 West 168th Street, NY 10032, United States. jae2109@columbia.edu
Telephone: +1-617-2567072 Fax: +1-212-305026
Received: September 5, 2011
Revised: January 2, 2012
Accepted: January 9, 2012
Published online: March 28, 2012

AIM: To study the clinical outcomes of treating vein of Galen aneurysmal malformations (VGAM), we assessed our patient cohort using standardized cognitive and functional measures.

METHODS: A retrospective review of patients with VGAM treated by a single practitioner between 2003 and 2009 was performed for this study. In addition to routine clinical assessment, all patients were evaluated for cognitive and functional impairment using validated measures including the Neurobehavioral Rating Scale-Revised, the Bicêtre outcome score, and the Barthel index.

RESULTS: Five patients underwent combined transarterial and transvenous embolization of their VGAM during the study period. VGAMs were classified based on angioarchitecture as either choroidal (1/5) or mural (4/5) according to the classification scheme of Lasjaunias. In total, 13 embolization procedures were performed consisting of 1 to 3 treatment stages per patient. Complete or near complete occlusion was achieved in 4 patients, while subtotal occlusion was achieved in 1 patient. During follow-up (median 62.6 mo), all patients were either unchanged or cognitively and neurologically intact.

CONCLUSION: VGAM can be safely and effectively treated by staged transarterial and transvenous embolization. Using this strategy, excellent long-term cognitive and functional outcomes can be achieved.

Keywords: Cognition, Embolization, Endovascular, Hemorrhage, Interventional neuroradiology, Neurological development, Outcomes, Vein of Galen aneurysmal malformation