Delay in treatment of vein of galen aneurismal malformation [Galen veni anevrizmal malformasyonunun tedavisinde gecikme]

Objective: to present a case of vgam in children referred late according to the same scale with already impaired function and retardation,we have attempted to improve her quality of life. clinical presentation: a 7-year-old girl with a history of a brief period congestive cardiac failure at 20-day age in her neonate caused by a vgam and improved with appropriate medical management. her bicêtre neonatal score was 20,but no intervention was undertaken until she suffered mental retardation or neurological deficits 1 month ago. at admission,she had hemiparesis of the left limbs and mildly retarded psychomotor development and her bicêtre admission score was 2. ct scanning showed subcortical calcifications. she got a remarkable recovery at 1-month follow-up after transarterial embolization using coils and onyx. conclusion: the congestive cardiac failure in vgam can be present during the neonatal period. use of bicêtre score to determine aggressiveness and timing of treatment may help in achieving appropriate treatment and aid in prognostication. hemorrhage and mental retardation are the part of the natural history of untreated vgam. in children referred late with already impaired functions or severe retardation,endovascular treatment can achieve satisfactory results.