Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Feb 11;10(2):e2180.
doi: 10.7759/cureus.2180.

Imaging Characteristics of Dural Arteriovenous Fistulas Involving the Vein of Galen: A Comprehensive Review

Mohammad W Kassem  1 , Paul J Choi  1 , Joe Iwanaga  2 , Martin M Mortazavi  3 , R Shane Tubbs  4
Affiliations
Review

Imaging Characteristics of Dural Arteriovenous Fistulas Involving the Vein of Galen: A Comprehensive Review

Mohammad W Kassem et al. Cureus. .

Abstract

Vein of Galen aneurysmal malformation (VGAM) is a rare angiopathy, which most commonly presents in infancy. Although very rare, it is associated with high morbidity and mortality rates. In order to minimize such morbid rates, a prompt diagnosis followed by a timely initiation of management is crucial. Multiple antenatal and postnatal imaging techniques for the diagnosis have been described and discussed in the literature. However, to our knowledge, a comprehensive review exploring such a list of imaging options for VGAM has never been established. We aim to review the diagnostic tools to aid in better understanding of the investigative modalities physicians may choose from when treating patients with a VGAM.

Keywords: aneurysmal malformation; arteriovenous fistula; diagnosis; imaging; prenatal; vein of galen.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Schematic drawing of the pathomechanism of a vein of Galen aneurysmal malformation
Note the pericallosal artery and choroidal branches of the posterior cerebral artery (PCA) feeding the vein of Galen aneurysmal malformation (VGAM). Also note the prominent falcine sinus (FS) and the “accessory torcular” (AT). SS: straight sinus; T: torcular.
Figure 2
Figure 2. Sagittal T1-weighted MRI of a child with a VGAM (red arrow)
Also note the enlarged torcular herophili (TH) (green arrow). MRI: magnetic resonance imaging; VGAM: vein of Galen aneurysmal malformation.
Figure 3
Figure 3. MRI scout image noting the large VGAM (red arrow) seen in the patient shown in Figure 2
MRI: magnetic resonance imaging; VGAM: vein of Galen aneurysmal malformation.
Figure 4
Figure 4. Post-contrasted MRI of a patient with a large VGAM (red arrow) seen in Figures 2 and 3
MRI: magnetic resonance imaging; VGAM: vein of Galen aneurysmal malformation.
Figure 5
Figure 5. Axial T1-weighted MRI of the patient above with a large VGAM (red arrows)
MRI: magnetic resonance imaging; VGAM: vein of Galen aneurysmal malformation.
Figure 6
Figure 6. Coronal T2-weighted MRI of the patient above noting the large VGAM (red arrows)
MRI: magnetic resonance imaging; VGAM: vein of Galen aneurysmal malformation.
Figure 7
Figure 7. Angiogram, posterior view, noting the VGAM (red arrow), dilated TS (blue arrow), OOS variant (green arrow), and SS (yellow arrow)
VGAM: vein of Galen aneurysmal malformation; TS: transverse sinus; OOS: oblique occipital sinus; SS: sigmoid sinus.
Figure 8
Figure 8. Lateral skull radiograph noting a VGAM (red arrow)
VGAM - vein of Galen aneurysmal malformation
See this image and copyright information in PMC

References

    1. Endovascular treatment of vein of Galen dural arteriovenous fistula presenting as dementia. Huded V, Moeed SZ, Desouza R, Tripathi R, Nair R. Ann Indian Acad Neurol. 2014;17:451–454. - PMC - PubMed
    1. CT and color Doppler diagnosis of the vein of Galen malformations with hydrocephalus: a case series report of rare intracranial vascular malformations. Kebede T, Hawaz Y, Assefa G. http://europepmc.org/abstract/med/23930495. Ethiop Med J. 2013;51:77–83. - PubMed
    1. Prenatal diagnosis of a vein of Galen aneurysmal malformation using color Doppler ultrasound: a case report. Lopez-Cepero R, de la Vega A, Lynch L. http://europepmc.org/abstract/med/23767382. Bol Asoc Med P R. 2013;105:32–35. - PubMed
    1. Vein of Galen aneurysmal malformation-clinical and angiographic spectrum with management perspective: an institutional experience. Agarwal H, Sebastian LJ, Gaikwad SB, Garg A, Mishra NK. J Neurointerv Surg. 2017;9:159–164. - PubMed
    1. Galenic pial arteriovenous fistulas: Angioarchitecture, clinical presentation, and therapeutic considerations. George Zaki Ghali M. Clin Anat. 2017 - PubMed

LinkOut - more resources