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Aneurismas de la vena de galeno

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Aneurismas de la vena de galeno

  1. 1. aneurisma de la vena de galeno <ul><li>jaime diegopérez ramírez </li></ul><ul><li>jefe neurocirugia </li></ul><ul><li>hospital de pediatría del centro medico nacional siglo xxi </li></ul><ul><li>Instituto Mexicano del Seguro Social </li></ul>
  2. 2. <ul><li>sinonimia: </li></ul><ul><ul><li>aneurisma varicoso </li></ul></ul><ul><ul><li>aneurisma de la ampolla </li></ul></ul><ul><ul><li>malformación </li></ul></ul><ul><ul><li>fístula arteriovenosa </li></ul></ul>
  3. 3. <ul><li>Even when the disease has been recognized as a congenital condition, was first described in an adult of 49 years by Steinhel in 1895 </li></ul>
  4. 4. <ul><li>Clinically 3 different types: </li></ul><ul><ul><li>Newborn presentation ( high mortality) </li></ul></ul><ul><ul><li>Infants (prominent veins and hydrocephalus) </li></ul></ul><ul><ul><li>Adolescence and adults </li></ul></ul>
  5. 5. Clinical data <ul><li>Newborn </li></ul><ul><ul><li>Macrocephaly </li></ul></ul><ul><ul><li>Prominent frontal vein </li></ul></ul><ul><ul><li>Holosystolic trill </li></ul></ul><ul><ul><li>Cardiac failure </li></ul></ul>
  6. 6. Clinical data <ul><li>Infant </li></ul><ul><ul><li>Hydrocephaly </li></ul></ul><ul><ul><li>Mild intelectual deficit </li></ul></ul><ul><ul><li>Epilepsy </li></ul></ul>
  7. 7. <ul><li>Epilepsy </li></ul><ul><li>Mild neurocognitive deficit </li></ul><ul><li>headache? </li></ul><ul><li>Espontaneous hemorrage? </li></ul>
  8. 11. Clasification <ul><li>Thalamic AVM adyacent to </li></ul><ul><li>AV Fistulae </li></ul>Choroidal Mural
  9. 13. choroidal
  10. 14. mural
  11. 15. Clinical progression
  12. 16. Prognostic Scale Less than 8: poor prognosis, no treatment 9 to 12 more than 50% of survivors if treated acutely Above 12 good prognosis, programed intervention
  13. 17. Diagnostic studies <ul><li>Ultasound prenatal and neonatal </li></ul><ul><li>IRM with angiography </li></ul><ul><li>Angiography (interventional) </li></ul>
  14. 18. treatment <ul><li>Until 20th century by 40’s it was no treatment but in 1945 it was the first AVC (abrir, ver y cerrar) surgery </li></ul><ul><li>In 60’s was first described the 3 different prognostic groups. </li></ul><ul><li>Surgery era between 70’ and 80’ the surgical era </li></ul><ul><li>Latest 80’ and early 90’s endovascular embolization </li></ul>
  15. 19. Surgery <ul><li>There’s no efective surgical treatment </li></ul><ul><ul><li>clipping feeders </li></ul></ul><ul><ul><li>Shunting (not recomended) </li></ul></ul>
  16. 20. Embolization
  17. 21. Embolization
  18. 24. centro medico nacional siglo xxi siglo xxi <ul><li>6 casos </li></ul><ul><ul><li>4 neonatal presentation </li></ul></ul><ul><ul><ul><li>3 die, 1 lost in following </li></ul></ul></ul>

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