Vein of Galen malformation (adult presentation)

Case contributed by Dr Nick Tarasov

Presentation

Headaches, seizures, developmental delay. MRI examination performed for the first time.

Patient Data

Age: 30 years
Gender: Female

Vein of Galen aneurysmal malformation, compressing the Sylvian aqueduct.

Lateral and 3rd ventricles are moderately dilated without transependymal oedema. Deep cerebral veins, vein of Rosenthal, and superior cerebellar veins are dilated bilaterally.

Convexity subarachnoid space narrowing.

No diffusion restriction. Signal loss within the malformed vein of Galen seen on DWI due to T2 blackout effect; there is a mixture of dark and bright pixels even on the corresponding ADC map.

Dural venous sinuses seem unremarkable. 

No T2* blooming.

Case Discussion

It was a big surprise to reveal the vein of Galen malformation causing obstructive hydrocephalus in a 30-year-old patient. Such a diagnosis in adults is extremely rare and if left untreated it is associated with poor clinical outcome, with a reported 76.7% mortality rate.

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Case information

rID: 56238
Case created: 20th Oct 2017
Last edited: 3rd Nov 2017
Inclusion in quiz mode: Included
Institution: USMU

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