Images in Clinical Medicine
Neonatal Vein of Galen Malformation
N Engl J Med 2002; 346:1553May 16, 2002
- Article
Figure 1 Sonographic imaging of the brain of a neonate showed a dilated hypoechoic venous lesion within the tentorial hiatus. Computed tomographic (CT) angiography demonstrated a large arteriovenous malformation of the vein of Galen (Panel A, sagittal view; Panel B, axial view). No other cerebral abnormalities were found. Gradual endovascular embolization of the dilated venous sac and all but one feeding artery (which could not be occluded) reduced the central shunt in the vein of Galen, as documented by magnetic resonance angiography (Panel C, axial view). The child developed normally over the next six years, but then a sudden headache occurred, followed quickly by coma. CT revealed an intraventricular hemorrhage from the malformation and evidence of hydrocephalus. External drainage of the ventricle was instituted, and additional embolization was performed. Once the blood had been reabsorbed, the cerebrospinal fluid flow returned to normal and a shunt was not needed. The patient had motor weakness of the left leg and short-term memory loss. Three months later, the weakness had resolved and he had no further motor or other disability, but the memory disturbance had not resolved.
Bernhard Fischer, M.D.
Stefan Palkovic, M.D., Ph.D.
University of Münster, Münster D-48129, Germany- Citing Articles (1)
Citing Articles
1
Sergio G. Golombek, Shamiza Ally, Paul K. Woolf. (2004) A Newborn with Cardiac Failure Secondary to a Large Vein of Galen Malformation. Southern Medical Journal 97:5, 516-518
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