# Chemical abscess post vein of Galen aneurysmal malformation embolisation with ethylene vinyl alcohol copolymer

## TL;DR

A rare chemical abscess occurred in an infant after treatment for a brain malformation using a specific polymer, but it was successfully managed without surgery.

## Contribution

Reports a rare complication of chemical abscess following EVOH embolisation for VGAM in infants.

## Key findings

- An eight-month-old developed a chemical abscess after EVOH embolisation for VGAM.
- Chemical abscesses have a good prognosis and can be managed conservatively.
- Differentiating chemical abscess from other brain lesions is crucial for appropriate treatment.

## Abstract

Vein of Galen aneurysmal malformation (VGAM) is a rare congenital malformation characterised by arteriovenous fistulas between primitive choroidal arteries and the median prosencephalic vein, the embryonic precursor to the vein of Galen. Endovascular techniques have changed the management of these patients with improved prognosis. An eight-month-old with VGAM managed by endovascular embolisation using ethylene vinyl alcohol copolymer (EVOH) developed a chemical abscess - a rare complication. It was managed conservatively and showed promising clinical outcome.

Chemical abscesses following EVOH embolisation are scarce – with imaging differentials, which include brain abscess and onyx granuloma. Knowledge and successful identification of this entity are essential as its management as prognoses differ. Chemical abscess is managed conservatively and has a good prognosis.