Color Doppler Ultrasound and MRI Findings of Vein of Galen Malformation in a Newborn, a Case Report.

Abstract

The Vein of Galen aneurysmal malformation (VGAM) is a rare intracranial arteriovenous anomaly that has usually been diagnosed prenatally. We reported a near term boy, 2,140 grams body weight, with a large VGAM, who was diagnosed prenatally by color Doppler ultrasound. After birth, his APGAR scores were 2, 4, and 8, respectively. An emergency cranial ultrasound was performed promptly when his vital sign began to be stable. The image revealed a huge dilatation of the great vein of Galen, measured about 1.9 x 2.0 x 3.8 cm. in diameter, with mixed venous and arterial flow profiles. Abnormal dilatation of the right internal carotid artery, and circle of Willis were also identified and likely to be an arterial feeder to choroidal artery which directly draining into the great vein of Galen. MRI, MRA, and MRV of the brain were performed on the following day and also showed a huge aneurysmal dilatation of a median vein of prosencephalon (precursor of the great vein of Galen) and marked dilatation of falcine sinus. Torcular herophili, both transverse / sigmoid sinuses and both internal jugular veins showed abnormal dilatation on MRA and MRV. Endovascular transarterial embolization was planned to performe on this patient but his vital sign was not stable. He finally expired from severe congestive heart failure after 5 days of life.