Vein of Galen malformation (adult presentation)
Headaches, seizures, developmental delay. MRI examination performed for the first time.
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Vein of Galen aneurysmal malformation, compressing the Sylvian aqueduct.
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.
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.
- 1. Xu DS, Usman AA, Hurley MC, Eddleman CS, Bendok BR. Adult presentation of a familial-associated vein of galen aneurysmal malformation: case report. Neurosurgery. 67 (6): E1845-51; discussion 1851. doi:10.1227/NEU.0b013e3181fa00d8 - Pubmed
- 2. Kerolus MG, Tan LA, Lopes DK. Giant vein of Galen malformation in an adult. Radiology case reports. 12 (3): 585-589. doi:10.1016/j.radcr.2017.03.012 - Pubmed