Presentation
Progressive increase in head circumference, change in cardiovascular parameters.
Patient Data
Vein of Galen malformation with a large central varix. It receives supply predominantly from posterior choroidal arteries bilaterally, which had evolved from prior supply from anterior cerebral arteries. There is moderate arteriovenous shunting with drainage into the falcine sinus and torcula.
Case Discussion
The diagnosis of vein of Galen malformation was actually made antenatally. Postnatal MRI demonstrated a large malformation. As the neonate remained haemodynamically stable, treatment was delayed. Follow-up imaging demonstrated a marked increase in the size of the malformation and hydrocephalus. Therefore, endovascular treatment was subsequently undertaken.
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