JAMA Neurol: Incidence and Influencing of adverse prognostication of Galen malformed venous embolism

The main neurological complications of Galen's malformed venous embolism (VOGMs) are not yet known, and researchers recently examined the incidence and factors of neural complications during VOGMs perioperative surgerystudy, conducted in Toronto, Ontario, Canada, involved a total of 48 VOGM children, 33 of whom received intravascular therapy, and 33 patients were treated with vascular staging arterial embolism over 91 coursesThe main endpoint of the study was the incidence of perioperative neurological complications (within 1 week of embolism)Secondary outcomes are mortality, long-term neurological prognosis, and anatomical and management factors for neurological complicationsOf the 33 patientstreated with embolism, 31 were boys with a median age of 4 months for the first embolism, and 10 patients (30.3%) experienced major perioperative neurological complications, five of which diedSingle-factor logistic regression analysis showed that the internal brain veins were drained to the main venous sac of VOGM and the use of microcatheters with a far-end outer diameter greater than 2.0Fr were significant factors in the development of neurotic prognosisThe researchers summarized the experience, including the need for an epidural magnetic resonance venous imaging to assess the flow pattern of venous drainage in the brain, to avoid embolism entering the vein sac, to treat more far-end fistulas before the formation of a near-end fistula to avoid water-logged effects, and to use smaller (2.0 Fr ion) microcatheters during neonatal embolismstudies found that 10 Galen deformities treated for embolism (30.3%) had major perioperative neurological complications, half of which diedAlthough the adverse prognosis rate in children is already the lowest since the report, treatment and pre-treatment diagnostic methods need to be improved