Successful treatment of neonatal aneurysmal dilatation of the vein of Galen: the role of prenatal diagnosis and trans-arterial embolization

Abstract

We report a neonate with aneurysmal dilatation of the vein of Galen diagnosed prenatally by color Doppler sonography and MRI at 37 weeks' gestation. The child was treated by transarterial embolization of micro-coils 2 and 8 days after birth. The aneurysmal dilatation of the vein of Galen markedly decreased after embolization and the patient is developing normally at 2 years 5 months of age. Prenatal diagnosis and early intervention by transarterial embolization produced in a good outcome in this patient.

Vein of Galen Aneurysms: Presentation and Endovascular Management

“…Hence, following antenatal diagnosis of VGAM, early cesarean section or induction of labor following prenatal diagnosis can be helpful for cardiac evaluation and management [4,5,6]. …”

Clinical course and medical management of neonates with severe cardiac failure related to vein of Galen malformation

“…6 In the past, this was usually associated with rapid progression to multisystem organ failure (MOF) and death, despite vigorous treatment and supportive medical care. 7 In the past decade, endovascular treatment has emerged as the treatment of choice for VGAM presenting in infancy with heart failure. Embolisation, both of feeding arteries and draining veins, can result in considerable reduction in aneurysmal blood flow, and has produced encouraging results in selected infants with VGAM.…”

Vein of Galen Malformations: Case Report & Review

“…Ultrasound, Doppler, Computerized tomography (CECT) and magnetic imaging resonance (MRI) are useful radiological diagnostic tools for vein of Galen malformations [3]. To improve outcomes in survivors, transcranial sonography and fetal MR imaging can help in antenatal diagnosis [10]- [12]. Many cases are diagnosed only during autopsy as congestive heart failure occurs very early [7].…”