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Odontoid Normal Variant
Joseph Junewick, MD FACR
over 4 years ago
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Vein of Galen Aneurysm

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 8 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Infant male with heart murmur.


Case Images


Diagnosis

Vein of Galen aneurysmal formation

Findings

Multiple large vessels from the right cerebrum converge into a large midline vein.

Discussion

Vein of Galen aneurysms are rare congenital vascular malformations characterized by shunting of arterial blood into an enlarged vein dorsal to the tectum. VOGA develop between the 6th and 11th weeks of gestation after the formation of the circle of Willis. True VOGA are the result of abnormal communication of the choroidal vessels and the median porencephalic vein of Markowski; increased flow prevents involution of this embryonic vein.

VOGA are associated with abnormal development of the dural sinuses, venous endothelial hyperplasia and venous stenosis. Aneurysms develop because of increased flow and venous obstruction.

VOGA can present with congestive heart failure, seizure, and hydrocephalus. Vascular steal can lead to ischemia and gliosis. The younger the patient is at diagnosis, the poorer the outcome. VOGA can be successfully treated by endovascular techniques.

Reference

Jones BV, et al. Vein of Galen Aneurysmal Malformation: Diagnosis and Treatment of 13 Children with Extended Clinical Followup. AJNR (2002); 23:1717-1724.



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