Images in Neurology |

Vein of Galen Aneurysmal Malformation

Jyoti Kumar, MD, DNB; Atin Kumar, MD, DNB; Sudhir Gupta, MD
Arch Neurol. 2006;63(10):1500-1501. doi:10.1001/archneur.63.10.1500.
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A 1-month-old neonate presented with mild congestive heart failure and increased head circumference. Magnetic resonance imaging of the brain was performed. Axial T2-weighted magnetic resonance images (Figure 1) showed a large flow void behind the region of the third ventricle with few tortuous vessels draining into its lateral walls. Magnetic resonance venography (Figure 2) demonstrated the enlarged venous varix and a prominent falcine sinus cephalad to the straight sinus. There was mild associated hydrocephalus. A diagnosis of “mural” type of vein of Galen aneurysmal malformation (VGAM) was made. The patient responded well to medical therapy for heart failure and is presently doing well at 3 months' follow-up. He is scheduled to undergo transcatheter embolization at about 8 months of age.

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Figure 1.

Two consecutive T2-weighted axial images (A and B) show a large flow void behind the third ventricle with few tortuous vessels draining into it.

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Figure 2.

Time of flight magnetic resonance venography shows the vein of Galen aneurysmal malformation. A prominent falcine sinus (arrow) is seen cephalad to the straight sinus and is draining the aneurysm into the sagittal sinus.

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