Prenatal diagnosis of thrombosed aneurysm of vein of Galen

Abstract

Aneurysm of the vein of Galen in the fetus is a rare malformation that has been described in a small number of case reports. Thrombosis of aneurysm of the vein of Galen is a rare occurrence reported in postnatal cases. We report a case of thrombosis of vein of Galen aneurysm occurring in a fetus of 21 weeks' gestation. The fetus showed an echogenic mass posterior and superior to the thalamus. It also showed dilated dural venous sinuses, dilated neck vessels, cardiomegaly and minimal ascites. The pregnancy was terminated and autopsy confirmed the diagnosis. The present case is the first report of the prenatal sonographic features of this condition in the literature. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.

Ultrasound Diagnosis of Congenital Brain Anomalies

“…Demonstration of blood flow in the cystic structure enables the diagnosis of an aneurysm of the vein of Galen to be made, as opposed to that of an abnormality of other intracranial midline structures, for example arachnoid or porencephalic cyst, Dandy-Walker malformation or intracerebral hematoma. However, when a clot has formed, it may be iso-or even hyperechoic (Vijayarghavan et al, 2006). Prognosis of aneurysm the vein of Galen is poor when cardiac failure and hydrops is present.…”

A Review of Findings in Fetal Cardiac Section Drawings

“…This can result from, or be present in, many different conditions, 43 such as endocardial fibroelastosis, fetal anemia, 44 storage disorders, ischemia, 45 infections, 46,47 atrioventricular and semilunar valve regurgitation after tachycardia, and an atrioventricular block. Some extreme forms of shunts, 48 such as a vein of Galen "aneurysm" (in fact a varix) 49,50 and chorioangioma, and obstructive lesions (aortic stenosis, idiopathic infantile aortic calcinosis, premature closure of the ductus, a true knot of the cord, and tumors in the outflow tracts) also cause global enlargement. Finally, an apparent enlargement (with a normal heart but a too-small chest) may be found in severe intrauterine growth restriction, skeletal dysplasias, and severe oligohydramnios from absent renal function (renal agenesis and multicystic kidney dysplasia).…”

Spontaneous thrombosis of neonatal vein of Galen malformation

“…The turbulent vascular flow in the cystic structure detected by pulsed and color Doppler ultrasonography enables the diagnosis of a VGM and helps distinguish it from other abnormal intracranial midline structures, such as arachnoid or porencephalic cysts, Dandy-Walker malformations, or intracerebral hematomas. 29 Additionally, it can help determine the presence of hydrocephalus and assess the status of the fetal cardiovascular system. Postnatally, ultrasound can be used to demonstrate hemodynamic changes associated with the malformation, including assessing the status of the shunt on serial studies.…”

“…Untreated VGMs have a poor prognosis. 14,29 The degree of shunting determines the overall prognosis and management. High-flow shunts across the malformation can lead to high-output congestive heart failure.…”

“…Imaging evidence of encephalomalacia is thus considered a relative contraindication to endovascular therapy. 9,29 Patients refractory to medical therapy require emergency endovascular embolization.…”