DOI: 10.1097/RUQ.0000000000000222

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PMID: 27580088

Issn Print: 0894-8771

Publication Date: 2016/12/01


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Vein of Galen Aneurysmal Malformation

Aya Y. Michaels; Shreya Sood; Mary C. Frates

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Excerpt

A pregnant woman (gravida 1, para 0) underwent a fetal ultrasound examination at 32 weeks' gestational age (GA) at an outside institution that demonstrated a 2-cm anechoic midline structure within the fetal brain containing prominent vascular flow on Doppler examination. The mass connected to an enlarged midline falcine sinus, which drained into the sagittal sinus. The brain parenchyma and ventricular size were normal. The patient was transferred to our institution at 37 weeks' GA. Fetal ultrasound reconfirmed the vascular anomaly (Fig. 1). Fetal magnetic resonance (MR) images demonstrated a 2.1-cm mass within the fetus's quadrigeminal plate cistern that corresponded to the sonographic abnormality (Fig. 2, Supplemental Digital Content 1, http://links.lww.com/RUQ/A116). An echocardiogram was normal.
The patient was induced at 39 weeks and 6 days and had an uncomplicated vaginal delivery. Brain MR performed on the day of birth demonstrated a large dilated median prosencephalic vein (MPV) and adjacent arterial feeders (Fig. 3). An echocardiogram showed no structural heart disease but high cardiac output. After several days of observation in the neonatal intensive care unit including a transcranial ultrasound at the age of 6 days (Fig. 4), the infant was discharged in stable condition. He will be followed with serial head ultrasounds and head circumference checks, with the plan of intervention when he is older.

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