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ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Obstructive hydrocephalus due to high-volume liquid embolic agent embolization for management of pediatric arteriovenous malformations: illustrative case.

Alex Devarajan, Chi Le, Tomoyoshi Shigematsu, Alejandro Berenstein, Johanna T Fifi, Peter F Morgenstern

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alex DevarajanDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue; Floor 8, New York, NY, 10029, USA. alex.devarajan@icahn.mssm.edu.ORCID http://orcid.org/0000-0002-7728-9573
Chi LeDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue; Floor 8, New York, NY, 10029, USA.
Tomoyoshi ShigematsuDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue; Floor 8, New York, NY, 10029, USA.
Alejandro BerensteinDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue; Floor 8, New York, NY, 10029, USA.
Johanna T FifiDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue; Floor 8, New York, NY, 10029, USA.
Peter F MorgensternDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue; Floor 8, New York, NY, 10029, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAs embolization techniques for the management of vein of Galen malformations (VOGM) continue to evolve, aggressive embolization for complete obliteration is increasingly favored. Transvenous embolization with the retrograde pressure cooker technique, involving high volumes of liquid embolic agent (LEA), has gained popularity to achieve complete obliteration. Though clinical outcomes have improved, there is limited discussion regarding the impact of high-volume embolization on the juvenile brain. CASE: A 2-year-old boy without previous history of hydrocephalus presented with tri-ventricular hydrocephalus and signs of clinical deterioration 6 days after complete cure of his VOGM by transvenous embolization with Onyx, n-BCA, and coils. The patient was emergently taken for endoscopic third ventriculostomy (ETV), which was successful. On long-term follow-up, the patient did not experience any permanent neurologic deficits and continued to demonstrate progression in milestones.

conclusionsThough embolization is viewed as the appropriate strategy for management of VOGM-related hydrocephalus, patients receiving high-volume LEA embolization may be at increased risk for obstructive hydrocephalus secondary to mass effect even without previous history of hydrocephalus. As guidelines continue to favor aggressive embolization for cure, neurosurgeons should maintain a high degree of suspicion for signs of new-onset hydrocephalus when following VOGM patients after high-volume embolization.

Indexed as

Embolization, TherapeuticHydrocephalusIntracranial Arteriovenous MalformationsVein of Galen MalformationsChild, PreschoolHumansMalePolyvinylsVentriculostomyPolyvinylsHydrocephalusTherapeutic embolizationVein of Galen malformationsVentriculostomy

Identifiers

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.