ABSTRACT
An aneurysm of the vein of Galen is a rare arteriovenous malformation of the central
nervous system. Fetal manifestations have included nonimmune hydrops, hydro-cephalus,
and intracranial hemorrhage. This anomaly may be diagnosed prenatally by several imaging
modalities. A cystic cranial mass was identified by ultrasound in a fetus at 30 weeks
gestation. Both pulsed-wave Doppler and color-velocity imaging studies suggested aneurysm
of the vein of Galen as the most likely diagnosis. The fetus demonstrated no evidence
of hydrops on serial ultrasound examinations. A 2430 g female infant was delivered
vaginally at 35 weeks gestation. Postnatal management included transarterial embolization
of the vessels feeding the aneurysm with craniectomy, an intra-aneurysmal balloon,
and vascular microcoils. Hydrocephalus developed and a ventriculo-peritoneal shunt
was placed. The infant has grown appropriately in the first year of life. An aneurysm
of the vein of Galen may be diagnosed prenatally by real-time ultrasound, pulsed-wave
Doppler, color-velocity imaging, or magnetic resonance imaging. The presence of this
malformation should prompt close follow-up for the remainder of the pregnancy. Careful
obstetric management and early postnatal intervention may lead to a favorable outcome.
Keywords
Vein of Galen - aneurysm - prenatal diagnosis
