Perfusion brain scintigraphy studies in infants and children with malformations of the vein of Galen

Cerebral perfusion brain scintigraphy obtained in six unselected patients ( age newborn to 14 years) from among 50 children with vein of Galen malforma tions was used in conjunction with magnetic resonance imaging to determine the basis of the neurological and cognitive abnormalities in patients with vein of Galen malformations (VGMs). Five had a hemiparesis - persistent, tr ansient, or alternating. Four were developmentally delayed. Two had so far been cognitively normal and acquired a neurological deficit, following an e mbolization procedure. The school age patient had a nonverbal learning disa bility. Three had epilepsy and/or an abnormal electroencephalogram. Magneti c resonance imaging documented only the VGM, hydrocephalus and atrophy; one child with perinatal asphyxia had periventricular leukomalacia. Perfusion brain scintigraphy was normal in two (a normal infant, and a toddler with a hemiparesis and aphasia). Abnormal findings included: left parietal hypope rfusion, fronto-temporal atrophy, patchy flow; left fronto-temporal hypoper fusion, left hemiatrophy, bilateral medial temporal hypoperfusion, right ce rebellar hypoperfusion; right temporal hypoperfusion, patchy flow; right he miatrophy, occipital hypoperfusion. Perfusion brain scintigraphy findings c orrelated better with focal neurological and cognitive defects than did mag netic resonance imaging.