Introduction: Vein of Galen malformations (VOGMs) describe a rare and complex group of congenital cerebrovascular anomalies that pose significant challenges in pediatric neurosurgery. This systematic review aims to evaluate the neurosurgical outcomes of patients with VOGMs, with a focus on the effectiveness of surgical treatments, postoperative recovery, and long-term neurological outcomes.
Methods: A comprehensive literature search was conducted across 4 databases, namely PubMed, Google Scholar, Scopus and Cochrane, using keywords ”vein of galen” and “surgical” among others. A total of 1,139 articles were screened to identify original studies reporting post-operative outcomes in patients undergoing any surgical intervention for correction of VOGM. Data analysis was conducted using IBM SPSS.
Results: Thirty-nine records were included in this study, encompassing a total of 315 patients. Types of VOGMs were majorly choroidal among identified studies (45.5%), with other prevalent types being mural (37.3%), mixed (15.6%) and aneurysmal dilation (1.4%). Routine diagnostic modalities across these studies were angiography and computed tomography scans. Other cases also employed vertebral angiograms and fetal echocardiograms for detection in-utero. Endovascular embolization was the most commonly performed procedure among all these studies. Among these patients, 70% reported positive results. A few intraoperative complications were reported, which include ischemic stroke, convulsions, and pulmonary hypertension. A quantitative analysis was performed on the reported post-surgical complications. Neonates accounted for 50.7% of these instances, followed by adults (41.2%), infants (29.9%), and children (11.1%). Common causes for mortality post procedure were catheter and embolization related complications, venous hypertension, and multi-organ failure.
Conclusion : This study concludes relatively higher success rate of surgical interventions among VOGM patients. However, complications across different age groups still persist. Future studies should focus on improving patient outcomes following endovascular embolization.
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