Vein of Galen Malformation

Arteriovenous malformation of the vein of Galen, also known as vein of Galen aneurysm, is a distinct intracranial anomaly characterized by a midline, deeply located, high-flow lesion with an extremely complex vascular architecture. Although they represent fewer than 1% of all cerebral arteriovenous malformations seen in children and adults, almost all cases diagnosed in the fetus and neonate involve the vein of Galen. 1,2 During the perinatal period, a timely diagnosis is of paramount importance because the large systemic shunting within the fetal brain often results in a substantial steal of blood, potentially leading to cardiac failure, hydrops, and perinatal death. 1-4 Prenatal diagnosis of vein of Galen malformation has been documented by several authors.2 In this report, we present an additional case that was evaluated further with the recently developed three-dimensional (3D) power Doppler angiographic imaging modality. This new technique provided us with improved images of the malformation in utero, which were helpful for characterizing the vascular anatomic features of the lesion before planned delivery and neonatal treatment.