Vein of Galen Aneurysmal Malformation: Diagnosis and Treatment of 13 Children with Extended Clinical Follow-up
Blaise V. Jonesa,
William S. Balla,
Thomas A. Tomsickb,
Justin Millarda and
Kerry R. Cronec
a Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
b Department of Radiology, University Hospital, University of Cincinnati, Cincinnati, OH
c Department of Neurosurgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
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FIG 1. Images from the case of a 19-month-old patient with mild hydrocephalus and engorged scalp veins.
A, Sagittal view T1-weighted MR image shows the markedly enlarged median prosencephalic vein of Markowski, characteristic of VGAM (arrow). Arterial feeders can be seen along the anterior wall of the vein.
B, The complex arterial maze (arrows) is well seen on this conventional angiogram obtained with injection of the left vertebral artery. Coils can be seen along the right side of the varix, occluding several arterial feeders.
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FIG 2. Images from the case of a 3-month-old triplet with worsening congestive heart failure.
A, Volume-rendered MR angiogram shows, from an inferior prospective, the arterial feeders supplying the lesion from the left side (arrows).
B, Carotid injection during arterial embolization procedure performed when the patient was 6 months old shows residual flow to the lesion from pericallosal and posterior choroidal arteries (arrowheads).
C, Coronal view fast spin-echo T2-weighted MR image obtained 6 years after embolization shows continued patency of the varix and mild enlargement of extra-axial fluid spaces.
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