Wednesday, March 25, 2009



The Vein of Galen is a large blood vessel located at the base of the brain underneath the hemispheres. Its main job is to drain the anterior and central parts of the cerebellum into sinuses located in the posterior fossa. Vein of Galen malformations involve missing capillaries which result in a direct link between a cerebral artery and vein. This does not allow the blood to slow down and drop off its oxygen and other nutrients as it normally would. Instead the blood flows rapidly from artery to vein and rapidly moves to the heart which cannot withstand this rush of blood. These malformations almost always cause congestive heart failure. Vein of Galen malformations are congenital defects and are sometimes seen on ultrasounds. Babies born with these defects can also have hydrocephaly because the enlarged vessel blocks the flow of CSF from the brain. Children with V of G malformations can also experience seizures and headaches, are slower learners and show signs of respiratory distress and cyanosis at birth. Babies who show CHF as the predominant symptom often die before birth or shortly thereafter. Shunting can markedly reduce the symptoms of macrocephaly and can often greatly, if not completely improve the life of the child. The best treatement for this disorder is by embolization of the affected vessel. The blood supply to the vessel is re-routed by the placement of a “man-made” embolis. This blocking action allows the blood flow to the heart to return to normal and often times the symptoms of the malformation dissipate. This procedure can allow the patient to lead a normal and active life.
http://www.childrenshospital.org/clinicalservices/Site2162/mainpageS2162P16.html
http://emedicine.medscape.com/article/1179888-overview
http://www.veinofgalen.co.uk/vog.htm



Nasal polyps are a fairly rare condition that occurs in approximately one to four percent of adults. They are benign growths that appear on the mucosal lining of the nasal passages and are teardrop in shape. Nasal polyps are most often seen in the opening into a sinus. Polyps most often occur in those who experience chronic sinusitis, have asthma, and/or endure frequent nasal and sinus allergies. There is a slightly higher incidence in males than compared to females. These types of polyps are very rare in children but are sometimes seen in those that have been diagnosed with cystic fibrosis. Some common symptoms of nasal polyps are a runny nose, congestion, decreased sense of smell or taste, headaches, and itching around the eyes. These polyps can sometimes cause breathing difficulties depending on their size and origin. It is unknown why and how nasal polyps actually appear but they are thought to be influenced by many different factors such as allergies, family history, and age to name a few. It is thought that nasal polyps are caused when normal nasal and sinus mucosa swell and fill up with fluid. Others believe polyps are their own entity. There are a few different ways of testing for nasal polyps. One way is to have a nasal endoscopy performed. For this exam a doctor will place a scope, or small camera, up into the nostril into the nasal cavity and literally look for the polyps. Other ways include allergy tests, CT scans, and Cystic Fibrosis tests. Treatment often involves trying to shrink the polyp or completely get rid of it. Corticosteroids are often used to try and reduce the size of the polyp or polyps. Either a polypectomy or endoscopic surgery on the sinuses can be performed in order to remove the polyp from the nasal passage. The type of surgery depends on the size and amount of the polyps. Some of the best ways to reduce ones chances of having polyps is by using a nasal rinse or a nasal lavage of saline, managing ones allergies and asthma, practicing good hand hygiene and humidifying ones home.

All information used in this blog as well as additional information on nasal polyps can be found on the following websites:
Mayoclinic.com
http://emedicine.medscape.com/article/994274-overview