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[Cerebral arteriovenous malformation (author's transl)]
Insights
Congenital cerebral arteriovenous malformations can cause immediate congestive heart failure in newborns. Surgical resection offers a potential treatment, as demonstrated by one infant
Area of Science:
- Neurology
- Pediatrics
- Cardiology
Background:
- Congenital cerebral arteriovenous malformations (AVMs) are rare vascular anomalies.
- Early-onset congestive heart failure is a critical complication in neonates with AVMs.
Observation:
- Three neonates presented with immediate congestive heart failure.
- Clinical signs included scalp murmurs, cardiac murmurs, gallop rhythm, cardiomegaly, and hepatomegaly.
- Diagnosis was confirmed via carotid arteriography.
Findings:
- Two cases involved aneurysms of the great cerebral vein of Galen (vena cerebri interna Galeni).
- One case had an aneurysm in the sylvian artery distribution.
- Two patients died due to the non-feasibility of surgical intervention.
- One patient underwent successful resection of the AVM and is recovering well.
Implications:
- Early diagnosis and intervention are crucial for managing neonatal congestive heart failure secondary to AVMs.
- Surgical resection can be a viable treatment option for select cases.
- This highlights the severe hemodynamic impact of AVMs in the neonatal period.
Abstract:
Three cases of congenital cerebral arteriovenous malformation are presented. They all developed congestive heart failure in the first day of life. The main clinical findings were a continuous murmur heard over the scalp, an ejection murmur at the upper left sternal border, gallop rhythm, cardiomegaly and hepatomegaly. Diagnosis was confirmed in all by carotideal arterography. Two had aneurysm of the vena cerebri interna Galeni and in the other, the aneurysm was localized in the area irrigated by the sylvian artery. The two former died after surgery was considered not feasible. The latter had his malformation resected. Two years after operation he is doing well.