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.
Papanagiotou P, Rohrer T, Grunwald IQ, Politi M, Gortner L, Reith W. Vein of Galen Aneurysmal Malformation Treated With Onyx. Arch Neurol. 2009;66(7):906–907. doi:10.1001/archneurol.2009.99
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