Prenatal Diagnosis of Vein of Galen Malformation: A Multidisciplinary Challenge

ABSTRACT

Vein of Galen aneurysmal malformation (VGAM) is a rare congenital arteriovenous malformation of the choroid plexus situated within the roof of the third ventricle. If large, it leads to an extracardiac left-to-right shunt featuring as a high output heart failure in the neonate. In our case of VGAM, hypoxic-ischemic brain lesions due to the steal phenomenon could be demonstrated prenatally. In a multidisciplinary clinical setting, withdrawal of active care and initiation of good end-of-life care was decided on and carried through.

KEYWORDS

Vein of Galen - arteriovenous malformation - steal phenomenon - end-of-life care

REFERENCES

• 1 Sepulveda W, Vanderheyden T, Pather J, Pasquini L. Vein of Galen malformation.  J Ultrasound Med. 2003;  22 1395-1398
• 2 Bhattacharya J J, Thammaroj J. Vein of Galen malformations.  J Neurol Neurosurg Psychiatry. 2003;  74 i42-i44
• 3 Epelman M, Daneman A, Blaser S I et al.. Differential diagnosis of intracranial cystic lesions at head US: correlation with CT and MR Imaging.  Radiographics. 2006;  26 173-196
• 4 Benacerraf B R. Ultrasound of Fetal Syndromes. Philadelphia; Churchill Livingstone 1998: 14-18
• 5 Werner H, Daltro P, Bulas D. Vein of Galen malformation. http://www.TheFetus.net
• 6 Patton D J, Fouron J C. Cerebral arteriovenous malformation: prenatal and postnatal central blood flow dynamics.  Pediatr Cardiol. 1995;  16 141-144
• 7 Brunelle F. Brain vascular malformations in the fetus: diagnosis and prognosis.  Childs Nerv Syst. 2003;  19 524-528
• 8 Ruano R, Benachi A, Aubry M C, Brunelle F, Dumez Y, Dommergues M. Perinatal three-dimensional color power Doppler ultrasonography of vein of Galen aneurysm.  J Ultrasound Med. 2003;  22 1357-1362
• 9 Chisholm C A, Kuller J A, Katz V L, McCoy M C. Aneurysm of the vein of Galen: prenatal diagnosis and perinatal management.  Am J Perinatol. 1996;  13 503-506
• 10 Breysem L, Bosmans H, Dymarkowski S et al.. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis.  Eur Radiol. 2003;  13 1538-1548