Image 3 This is the vein of Galen and the straight sinus.
Vein of Galen aneurysm or vein of Galen malformation
Vein of Galen malformation is a congenital anomaly that usually appears late in pregnancy. In this case the diagnosis was made in the 3rd trimester. Often 3rd trimester sonography is still not routinely performed in many centers, hence some cases are diagnosed only during the neonatal period when clinical symptoms arise. The usual presenting feature in post natal life is cardiac failure. It is for this reason that vein of Galen aneurysm or malformation should be suspected in cases of neonatal cardiac insufficiency.
The vein of Galen is located in the posterior part of the cerebrum and drains the anterior and central parts of the fetal brain. It drains into the straight sinus posteriorly. The vein of Galen aneurysmal malformation results from arteriovenous shunting of blood and is the most common arteriovenous malformation in the fetus. This anomaly may be associated with hydrocephalus resulting from obstruction of the CSF outflow. There are 5 variants of vein of Galen malfoimations described in the literature. If the vein of Galen aneurysm undergoes thrombosis, the sonographic appearance may change with an echogenic mass seen in this location.
Most fetuses develop cardiac insufficiency or intracranial hemorrhage immediately after birth. Quick intervention maybe the only hope for such neonates.
1) Arachnoid cyst are not vascular
2) Porencephalic cysts are the result of intracranial hemorrhage and are not vascular.
3) Choroid plexus papilloma masses are located within the lateral or 3rd ventricles and are hyperechoic.
4) Choroid plexus cysts occur within the ventricles and are not vascular.
1) Callen, P. Ultrasonography in obstetrics and gynecology
2) Ruano, R., Benachi, A., Aubry, M., et al.
“Perinatal Three-dimensional Color Power Doppler Ultrasonography of Vein of
Galen Aneurysms” JUM., December 2003 22:1357-1362
3) Rumack, C. Diagnostic Ultrasound
4) Suma, V., Marini, A., Saia, O., Rigobello, L.
“Vein of Galen Malformation”. Sonoworld.com. 1991
5) Images from
Ultrasound-images.comcourtesy of Dr. Anita Kaul, India