Vein of Galen Malformation

Findings:
MR images show a massively enlarged Vein of Galen, stright sinus, and torcula, associated with markedly enlarged posterior cerebral arteries. The arteriogram shows a nidus of vessels in the region  of the posterior third ventricle, with a large aneurysmal draining venous structure.

Discussion:
Classification:
    I- direct AV fistula between arteries and VoG
    II- thalamic AVM
    III- mixture of I and II- neonate with CHF
    IV- AVM with veins that drain into VoG
70% have associated venous anomalies (absent/interrupted straight sinus, persistent falcine sinus). Posterior choroidal, ACA, PCA, thalamoperforators, perimesencephalic vessels are most common arterial supply. Associated syndromes include Turner's and Gorlin's (BRBNS).

reference: Osborn, A., Tong, K. Handbook of Neuroradiology: Brain and Skull. 1996:Mosby-Year Book, pp. 365-66.

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