{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:02:33Z","timestamp":1781521353711,"version":"3.54.1"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Life"],"abstract":"<jats:p>The vein of Galen malformations (VoGMs) is mainly correlated with the retention of an embryonic pattern of vascularity, inducer of vein of Galen dilation, and formation of arteriovenous communications that give rise to the risk of systemic shunting, causing cardiac dysfunction, vascular steal, and venous hypertension. This is a rare cerebral vascular malformation in the newborn, accounting for 1% of all cerebral arteriovenous malformations and occurring in approximately 1 in 25,000\u201350,000 live births. We review nine cases of newborns diagnosed with vein of Galen malformations (VoGMs) to assess whether this pathology demonstrates a marked improvement over the past 13 years in diagnostic accuracy, treatment approaches, and patient survival rates within our clinic. Medical treatment was focused on providing inotropic support and tightly controlled peripheral and pulmonary vasodilation with the aim of overriding the effects of high output heart failure. Most of the patients underwent liver failure and flow-mediated pulmonary hypertension, while half of the newborns expressed anomalies of the nervous system due to impaired cerebral hemodynamics. Given the unavailability of endovascular treatment in our unit, which predisposes the newborns to a higher vital risk, we recognize the importance of delivering tailored intensive care aimed at maintaining cardiorespiratory and hemodynamic stability until a curative intervention can be performed in a specialized center.<\/jats:p>","DOI":"10.3390\/life15101536","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T09:12:23Z","timestamp":1759223543000},"page":"1536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vein of Galen Malformation\u2014Experience of the Last 13 Years in a Reference Center from South-Eastern Europe"],"prefix":"10.3390","volume":"15","author":[{"given":"Ana Mihaela","family":"Bizubac","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Neonatal Intensive Care Unit, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Alexandra","family":"Fleaca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Carmen","family":"Heri\u0219eanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Neonatal Intensive Care Unit, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmina","family":"Nedelcu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Neonatal Intensive Care Unit, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Bratu","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Marcu","sequence":"additional","affiliation":[{"name":"Department of Radiology, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Filip","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Cardiology, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7778-0477","authenticated-orcid":false,"given":"C\u0103t\u0103lin","family":"C\u00eerstoveanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Neonatal Intensive Care Unit, \u201cMarie-Sklodowska Curie\u201d Children\u2019s Emergency Hospital, 20 Constantin Br\u00e2ncoveanu Street, District 4, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","first-page":"302","article-title":"Les an\u00e9vrysmes de la veine de Galien. Etude angiographique et consid\u00e9rations morphog\u00e9n\u00e9tiques [Aneurysms of the vein of Galen. Angiographic study and morphogenetic considerations]","volume":"33","author":"Raybaud","year":"1987","journal-title":"Neurochirurgie"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1053\/j.sult.2011.02.001","article-title":"Cerebral venous development in relation to developmental venous anomalies and Vein of Galen aneurysmal malformations","volume":"32","author":"Pearl","year":"2011","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_3","first-page":"136","article-title":"Persisting abnormal embryonic vessels in intracranial arteriovenous malformations","volume":"369","author":"Raybaud","year":"1986","journal-title":"Acta Radiol. Suppl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/BF00263834","article-title":"Congestive cardiac manifestations from cerebrocranial arteriovenous shunts. Endovascular management in 30 children","volume":"7","author":"Mann","year":"1991","journal-title":"Childs Nerv. Syst."},{"key":"ref_5","first-page":"1717","article-title":"Vein of Galen aneurysmal malformation: Diagnosis and treatment of 13 children with extended clinical follow-up","volume":"23","author":"Jones","year":"2002","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E9","DOI":"10.3171\/2009.8.FOCUS09161","article-title":"The putative role of the venous system in the genesis of vascular malformations","volume":"27","author":"Aboian","year":"2009","journal-title":"Neurosurg. Focus"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Lasjaunias, P. (1997). Vascular Diseases in Neonates, Infants and Children, Springer. Vein of Galen Aneurysmal Malformation, Pierre Lasjaunias.","DOI":"10.1007\/978-3-662-10740-9"},{"key":"ref_8","first-page":"43","article-title":"Vein of Galen malformations: Review","volume":"52","author":"Gupta","year":"2004","journal-title":"Neurol. India"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/BF00801914","article-title":"Cerebral arteriovenous malformation: Prenatal and postnatal central blood flow dynamics","volume":"16","author":"Patton","year":"1995","journal-title":"Pediatr. Cardiol."},{"key":"ref_10","first-page":"185","article-title":"The role of dural anomalies in vein of Galen aneurysms: Report of six cases and review of the literature","volume":"8","author":"Lasjaunias","year":"1987","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1007\/s00134-002-1381-8","article-title":"Severe cardiac failure in newborns with VGAM. Prognosis significance of hemodynamic parameters in neonates presenting with severe heart failure owing to vein of Galen arteriovenous malformation","volume":"28","author":"Chevret","year":"2002","journal-title":"Intensive Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00381-025-06936-9","article-title":"Obstructive hydrocephalus due to high-volume liquid embolic agent embolization for management of pediatric arteriovenous malformations: Illustrative case","volume":"41","author":"Devarajan","year":"2025","journal-title":"Childs Nerv Syst."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1038\/sj.jp.7211752","article-title":"Systemic haemodynamics in infants with vein of Galen malformation: Assessment and basis for therapy","volume":"27","author":"Patel","year":"2007","journal-title":"J. Perinatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/s41390-022-02064-1","article-title":"Vein of Galen aneurysmal malformation: Rationalizing medical management of neonatal heart failure","volume":"93","author":"Cory","year":"2023","journal-title":"Pediatr. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"F144","DOI":"10.1136\/fn.87.2.F144","article-title":"Clinical course and medical management of neonates with severe cardiac failure related to vein of Galen malformation","volume":"87","author":"Frawley","year":"2002","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/BF00298261","article-title":"Hydrodynamics in vein of Galen malformations","volume":"8","author":"Zerah","year":"1992","journal-title":"Childs Nerv. Syst."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S376","DOI":"10.4103\/0028-3886.332279","article-title":"Hydrocephalus in Vein of Galen Malformations","volume":"69","author":"Paramasivam","year":"2021","journal-title":"Neurol India"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S317","DOI":"10.4103\/2152-7806.182415","article-title":"Pediatric knowledge update: Approach to the management of vein of Galen aneurysmal malformations in neonates","volume":"7","author":"Hansen","year":"2016","journal-title":"Surg. Neurol. Int."},{"key":"ref_19","unstructured":"Thomas, J.A., and Mitesh, V.S. (2009). Chapter 16\u2014Pediatric Central Nervous System Vascular Malformations. Stroke in Children and Young Adults, W.B. Saunders Company. [2nd ed.]."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/BF00441544","article-title":"Evaluation of vein of Galen arteriovenous malformation in newborns by two dimensional ultrasound, pulsed and colour Doppler method","volume":"148","author":"Vaksmann","year":"1989","journal-title":"Eur. J. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00234-014-1455-7","article-title":"Cranial Doppler ultrasound in Vein of Galen malformation","volume":"57","author":"Meila","year":"2015","journal-title":"Neuroradiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"707","DOI":"10.3174\/ajnr.A7891","article-title":"Doppler Ultrasound Flow Reversal in the Superior Sagittal Sinus to Detect Cerebral Venous Congestion in Vein of Galen Malformation","volume":"44","author":"Schwarz","year":"2023","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_23","unstructured":"Joshua, A.C., Mary, E.D., Helen, F., Eduard, G., Deborah, K., Anthony, O.O., Lawrence, D.P., and Boris, T. (2018). Chapter 42\u2014Vascular Cerebral Anomalies. Obstetric Imaging: Fetal Diagnosis and Care, Elsevier. [2nd ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.3174\/ajnr.A6585","article-title":"Fetal and Neonatal MRI Predictors of Aggressive Early Clinical Course in Vein of Galen Malformation","volume":"41","author":"Arko","year":"2020","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"444","DOI":"10.3171\/2010.8.PEDS10231","article-title":"Evolution of treatment options for vein of Galen malformations","volume":"6","author":"Khullar","year":"2010","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e837","DOI":"10.1016\/j.wneu.2018.01.172","article-title":"Multimodality Management of Vein of Galen Malformations-An Institutional Experience","volume":"112","author":"Hosmann","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1227\/NEU.0b013e3182417be3","article-title":"Vein of Galen malformations in neonates: New management paradigms for improving outcomes","volume":"70","author":"Berenstein","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_28","first-page":"101717","article-title":"Arterial approach in vein of Galen aneurysmal malformation: Coils and EVOH","volume":"32","year":"2022","journal-title":"Interdiscip. Neurosurg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/s00381-010-1257-0","article-title":"Endovascular management of vein of Galen aneurysmal malformations. Influence of the normal venous drainage on the choice of a treatment strategy","volume":"26","author":"Pearl","year":"2010","journal-title":"Child\u2019s Nerv. Syst."},{"key":"ref_30","first-page":"236","article-title":"Neurointerventional Treatment of Vein of Galen Malformation (VGM): A Structured Review with a Proposal for the Comparison of Outcome Quality","volume":"2","author":"Brassel","year":"2023","journal-title":"J. Vasc. Dis."},{"key":"ref_31","first-page":"30","article-title":"Primer of Vein of Galen Malformation Management","volume":"5","author":"Reddy","year":"2022","journal-title":"J. Pediatr. Health Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1055\/s-0038-1666813","article-title":"Outcome of Neonates with Vein of Galen Malformation Presenting with Severe Heart Failure: A Case Series","volume":"36","author":"Tempera","year":"2019","journal-title":"Am. J. Perinatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e231","DOI":"10.1161\/STROKEAHA.123.043421","article-title":"Transuterine Ultrasound-Guided Fetal Embolization of Vein of Galen Malformation, Eliminating Postnatal Pathophysiology","volume":"54","author":"Orbach","year":"2023","journal-title":"Stroke"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.ajog.2023.11.1248","article-title":"Prenatal treatment of a vein of Galen malformation by embolization and 1-year follow-up","volume":"230","author":"Naggara","year":"2024","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3008","DOI":"10.37358\/RC.19.8.7475","article-title":"Presepsin-New Marker of Sepsis Romanian Neonatal Intensive Care Unit Experience","volume":"70","author":"Stoicescu","year":"2019","journal-title":"Rev. De Chim."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1136\/adc.78.6.548","article-title":"Congenital cardiac anomalies with vein of Galen malformations in infants","volume":"78","author":"McElhinney","year":"1998","journal-title":"Arch. Dis. Child."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s00246-002-0329-7","article-title":"Biatrial or left atrial drainage of the right superior vena cava: Anatomic, morphogenetic, and surgical considerations--report of three new cases and literature review","volume":"24","author":"Geva","year":"2003","journal-title":"Pediatr. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"102714","DOI":"10.3748\/wjg.v31.i9.102714","article-title":"Establishment and validation of a nomogram for predicting esophagogastric variceal bleeding in patients with liver cirrhosis","volume":"31","author":"Liang","year":"2025","journal-title":"World J. Gastroenterol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/10\/1536\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T09:37:29Z","timestamp":1759225049000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/10\/1536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":38,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["life15101536"],"URL":"https:\/\/doi.org\/10.3390\/life15101536","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}