Vein of Galen Aneurysmal Malformation: A Case Report With Insights Into Radiological Diagnosis Using Ultrasonography and Magnetic Resonance Imaging

TL;DR

This case report describes a rare brain malformation in a newborn diagnosed using ultrasound and MRI, emphasizing the importance of these imaging techniques for diagnosis and treatment planning.

Contribution

The paper provides a detailed case study demonstrating the complementary use of ultrasonography and MRI in diagnosing vein of Galen malformation in neonates.

Findings

Ultrasonography rapidly identified a large midline anechoic structure with intense flow in a neonate.

MRI and MRA precisely mapped the neurovascular anatomy, including arterial supply and absent deep venous drainage.

The case underscores the roles of ultrasonography and MRI in diagnosis and pretreatment planning for vein of Galen malformation.

Abstract

This report details the comprehensive radiological evaluation of a vein of Galen aneurysmal malformation in a neonate, using ultrasonography and magnetic resonance imaging. Vein of Galen malformation is a rare, congenital cerebral arteriovenous fistula and the leading cause of life-threatening high-output cardiac failure in neonates. A late preterm male infant presented with worsening tachypnea and generalized body swelling. Initial cranial ultrasonography revealed a large, midline anechoic structure with intense flow on color Doppler. Subsequent multiplanar magnetic resonance imaging and magnetic resonance angiography precisely delineated the neurovascular anatomy, showing a markedly dilated median prosencephalic vein, arterial supply from the left posterior cerebral artery, and the absence of normal deep venous drainage. This case highlights the critical, complementary roles of ultrasonography for rapid, accessible diagnosis and hemodynamic assessment, and magnetic resonance imaging for definitive anatomical mapping and pretreatment planning.

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