Presentation
One year old male presented with irritability, enlarged head and developmental delay.
Patient Data
Non contrast images demonstrate a well defined isodense rounded lesion in the midline posterior to the tectum and anterior to the tentorium with small peripheral focal calcification.
Post contrast images showed intense enhancement of the lesion with well defined border which compressed the aqueducts of sylvius resulting in significant dilatation of third and lateral ventricles.
Marked dilatation of third and lateral ventricles are noted due to compression of the aqueduct associated supratentorial brain parenchymal thinning.
The lesion is showing communication with venous sinus.
Carotid arteries and its branches as well as the vertebrobasilar circulation appear normal.
Case Discussion
Vein of Galen malformations (VOGM) are rare intracranial circulation defects and account for ~1% of intracranial vascular malformation. VOGM is composed of two internal cerebral vein and draining into the straight sinus 1.
VOGM is the result of an arteriovenous communication between the arterial network and prosencephalic vein. It occurs between 6th and 11 weeks of intrauterine life 2,3.
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