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Detection of an aneurysm of the vein of Galen following signs of cardiac overload in a 22‐week old fetus
Author(s) -
Hartung J.,
Heling K. S.,
Rake A.,
Zimmer C.,
Chaoui R.
Publication year - 2003
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.724
Subject(s) - medicine , aneurysm , arteriovenous fistula , radiology , fetus , cardiology , vein , tricuspid valve , jugular vein , fetal echocardiography , prenatal diagnosis , pregnancy , genetics , biology
Objectives To present early prenatal diagnosis of an aneurysm of the Vein of Galen by detecting signs of cardiac overload in a 22‐week old fetus. Case We report on a 22‐week old fetus presenting with dilation of the heart, tricuspid and mitral valve regurgitation, reversed flow in the aortic arch and dilated neck vessels. Evaluation of the fetal brain revealed a dilated left ventricle, signs of brain hemorrhage and an anechoic structure between the two hemispheres. Methods By using the conventional Doppler technique, an intracerebral fistula and dilated vein of Galen was visualized. The complex vascular structure was demonstrated using 3‐D color power angiography (3‐D CPA). To our knowledge, this is the earliest diagnosis of this vascular malformation. Conclusion Although signs of cardiac overload rarely appear before the third trimester in cases of arteriovenous fistulae, it was shown that these signs could lead to the correct diagnosis of an aneurysm of the vein of Galen. Additionally, we show that 3‐D CPA is a promising technique to visualize complex vascular structures and make them easier to understand. Copyright © 2003 John Wiley & Sons, Ltd.