Vein of Galen malformation

Case contributed by A.Prof Frank Gaillard

Presentation

Persistent severe high flow cardiac failure.

Patient Data

Age: 10 days old
Gender: Male

MRI brain

Modality: MRI

A very large vascular structure is located in the pineal region with aneurysmal dilatation. It receives blood predominantly from the vertebral arteries although some anterior supply is also suspected. Drainage is to the torcula and bilaterally to the internal jugular veins. 

Angiogram

Modality: DSA (angiography)

Selective injections of the left vertebral artery demonstrate strikingly fast shunting of contrast through the malformation with little parenchymal contrast blush.  Angiogram courtesy of Prof. Peter Mitchell. 

Case Discussion

This case illustrates typical appearances of a very high flow vein of Galen malformation. The patient is undergoing repeated embolisations of the arterial feeders. One of the challenges of treating this condition is the very small volumes of contrast one as available, and as a result often such treatments require multiple sessions. 

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Case Information

rID: 22778
Case created: 22nd Apr 2013
Last edited: 1st Nov 2015
Inclusion in quiz mode: Included

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