Bicêtre Neonatal Evaluation Score

The Bicêtre Neonatal Evaluation Score is calculated based on the neonate’s cardiac, cerebral, respiratory, hepatic and renal function. While this score is controversial (31,59), some centers apply it to guide treatment decisions in neonates presenting with VOGM. Other centers use less regimented approaches to discuss the clinical status of the child and each organ system in a comprehensive fashion to provide multidisciplinary guidance to families in tailored treatment planning. When emergency endovascular intervention is not indicated, the timing of endovascular embolization is controversial. Many centers opt to optimize medical management in the first few months of life and delay endovascular intervention to 6 months or older. Ultimately, the patient’s overall clinical status should inform treatment decisions and timing.

• • Bicêtre score <8: Palliative care may be indicated.
  • Bicêtre score 8≤12: Emergency endovascular intervention is indicated.
  • Bicêtre score >12: The patient may be managed medically until they are 3 or, at most, 5 months old, when endovascular intervention should be pursued regardless of symptoms (24,31).