A 1-month-old neonate presented with mild congestive heart failure and increased head circumference. Magnetic resonance imaging of the brain was performed. Axial T2-weighted magnetic resonance images (Figure 1) showed a large flow void behind the region of the third ventricle with few tortuous vessels draining into its lateral walls. Magnetic resonance venography (Figure 2) demonstrated the enlarged venous varix and a prominent falcine sinus cephalad to the straight sinus. There was mild associated hydrocephalus. A diagnosis of “mural” type of vein of Galen aneurysmal malformation (VGAM) was made. The patient responded well to medical therapy for heart failure and is presently doing well at 3 months' follow-up. He is scheduled to undergo transcatheter embolization at about 8 months of age.
Kumar J, Kumar A, Gupta S. Vein of Galen Aneurysmal Malformation. Arch Neurol. 2006;63(10):1500-1501. doi:10.1001/archneur.63.10.1500