Vein of Galen Malformations

Vein of Galen malformations are a very rare type of condition that affects the blood vessels of the brain and it occurs during embryonic development. This condition results from an abnormal communication between the arteries and the veins in the developing brain. The Vein of Galen is a large vein that is located deep in the base of the brain. Normally blood will flow slowly through the capillaries to allow the exchange of oxygen into the surrounding tissues. With this type of malformation the capillaries are missing. This allows the blood to flow directly from the arteries to the veins. With this type of flow it does not slow down and will not allow the release of oxygen and nutrients. The rush of blood from the brain can cause many problems. Since the blood flows almost straight to the heart so rapidly, the heart can become overwhelmed, thus possibly leading to congestive heart failure. The faster flow of blood may also interfere with the normal blood drainage, which may lead to hydrocephalus. This malformation is rare and develops in utero. This malformation is caused by the blockage of the normal flow or absorption of cerebral spinal fluid. Vein of Galen malformations can be placed in three categories. Group one is neonates that develop congestive heart failure and a noise made by blood turbulence. This is called an intracranial bruit. The second group is infants that present with developmental delays and abnormal enlargement of the head. The third group is comprised of older children who will suffer from possible seizures or epileptic fits. They are in danger of possible strokes. They will also have an enlarged head and have difficulties learning.
It is possible to detect these kinds of abnormalities during antenatal ultrasound scans. Most often it does not appear until after birth when the child experiences rapid heart failure. In severe cases while in utero the baby will have difficulty coping with the abnormal shunt and this will cause the baby to die. If the child survives through birth they will rapidly go into heart failure that can be treated medically. Even with medical treatment in some cases the heart failure is so severe that other organs will be affected and the baby will not survive. Those children who do not develop heart failure will develop the hydrocephalus. This can cause the child to be floppy and sometimes have slight developmental delays. Treatment for these children is possible when they are a few months of age. And although their heads will remain large, over time as they grow their bodies will catch up with and become proportional to their head size.
Embolization is the most effective treatment for this type of malformation. A small catheter is fed through the arteries until the defect is located. Materials will be placed by the surgeon in the artery to block the blood flow to form a clot. The materials used range from fast acting glue to small particles or coils. Although this procedure is not 100% successful on the first attempt the subsequent efforts will gradually close off the remaining blood flow. After treatment is successful patients will often make rapid advances in their development and may go on to lead normal healthy lives. Those children who do not receive treatment will become at risk for developing permanent brain damage. The permanent high pressure within the vessels may also lead to the development of seizures or stroke.

my information came from

http://www.childrenshospital.org/clinicalservices/Site2162/mainpages2162p16.html

http://www.veinofgalen.co.uk/vog.html

my pictures came from

http://www.emedicine.com/neuro/topic538.htm

Nasal Polyps

Nasal Polyps occur in the lining of the nasal cavity or sinuses. They are soft and non-cancerous. These growths are brought about by having a chronic inflammation of these linings. No one really knows what causes this chronic inflammation. Nasal polyps can affect anyone but they are more common in people over the age of forty and in those who have asthma, chronic sinus infections, hay fever and cystic fibrosis. These polyps rarely cause problems especially if they are smaller. The larger polyps can cause problems with breathing and can affect a persons’ ability to smell things properly.
It is believed that some causes of the chronic inflammation of the nasal lining might be bacterial or viral infections. In some cases it can be caused by allergies or the body’s reaction to a fungus. This inflammation causes the vessels in the nose and sinuses to accumulate water in the cells because they become more permeable. In time these vessels will sag because of the effect of gravity on the swollen tissues. The sagging vessels could develop into polyps. It is believed that people who are affected with a severe allergy to environmental fungus and children with cystic fibrosis are more likely to develop nasal polyps. People who have Churg-Stauss syndrome which is a rare disease that causes inflammation in the vessels are also very likely to develop nasal polyps. If a person has a sensitivity to NSAIDS or aspirin they are also likely to develop nasal polyps.
Some common symptoms of nasal polyps range from the simple runny nose to chronic sinus infections. Those affected complain of persistent stuffiness, a loss or decrease in the sense of smell. Complaints of dull headaches, snoring and chronic sinus infections have also been reported.
CT scans are used to test for nasal polyps by determining size, shape and the location of possible polyps. When a child has been diagnosed with having multiple nasal polyps, the doctor may decide to test the child for cystic fibrosis. This is done by doing a sweat test, which consists of measuring the amount of sodium chloride in the child’s perspiration. Small nasal polyps normally do not cause complications especially if there is only one. However, if the polyps are large or if there are several they can lead to some complications. Examples of complications are acute or chronic sinus infections, sleep apnea and altered facial structure which can lead to wide set eyes; this is most likely to occur in people with cystic fibrosis. Sleep apnea is a serious condition which causes an individual to stop breathing for short periods of times while sleeping.
Treatment for nasal polyps range from steroid treatments to surgery. Doctors will prescribe a corticosteroid nasal spray to relieve the inflammation and shrink the polyp. This treatment is usually prescribed if there are one or more small polyps. If this treatment proves ineffective the doctor may decide that surgery is the best option. Two types of surgery are used. The first is Polypectomy. This is a procedure in which the polyp is removed completely. The other type of surgery is known as an Endoscopic sinus surgery. In this surgery they not only remove the polyp, they also open the area of the sinuses where the polyps have been forming. In the cases where the chronic sinus infections have been caused by an environmental fungus the doctor may prescribe antifungal medications.

My information came from the following website.
http://www.mayoclinic.com/health/nasal-polyps/ds000498

My picture came from the following website.

http://www.ghorayeb.com/NasalPolyps.html