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Images in Neurology
June 2009

Vein of Galen Aneurysmal Malformation Treated With Onyx

Arch Neurol. 2009;66(7):906-907. doi:10.1001/archneurol.2009.99

A 4-month-old infant was referred to the pediatrics neurology clinic with macrocephaly. Her neurological status was normal. Sonography, magnetic resonance imaging (MRI) and angiography revealed a large vein of Galen aneurysmal malformation (VGAM) (Figure 1). The patient was treated endovascularly, using ethylene-vinyl alcohol copolymer (Onyx) as an embolic agent. Occlusion of the feeding arteries was complete, and there was no remaining flow into the VGAM (Figure 2). Follow-up MRI after 1 year showed that hydrocephalus persisted, whereas the VGAM had shrunk (Figure 2). The patient had development delay and seizures.

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