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Vein of Galen Aneurysmal Malformation
Anne G. Osborn, MD, FACR; Anna Illner, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Vein of Galen (VofG), vein of Galen aneurysmal malformation (VGAM), median prosencephalic vein (MPV) of Markowski
            • Synonyms

              • Vein of Galen "aneurysm," galenic varix
            • Definitions

              • Arteriovenous fistula (AVF) between pericallosal/deep choroidal arteries and embryonic MPV (precursor of VofG)
              • High flow through MPV prevents formation of vein of Galen; VGAM is misnomer

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Echocardiographic Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Image Interpretation Pearls

                                                • Reporting Tips

                                                  Selected References

                                                  1. Pop R et al: Flow control using Scepter(TM) balloons for Onyx embolization of a vein of Galen aneurysmal malformation. Childs Nerv Syst. 31(1):135-40, 2015
                                                  2. Mortazavi MM et al: Vein of Galen aneurysmal malformations: critical analysis of the literature with proposal of a new classification system. J Neurosurg Pediatr. 12(3):293-306, 2013
                                                  3. Berenstein A et al: Vein of Galen malformations in neonates: new management paradigms for improving outcomes. Neurosurgery. 70(5):1207-13; discussion 1213-4, 2012
                                                  4. Jagadeesan BD et al: Susceptibility-weighted imaging: a new tool in the diagnosis and evaluation of abnormalities of the vein of Galen in children. AJNR Am J Neuroradiol. 33(9):1747-51, 2012
                                                  5. Meila D et al: The persistent primitive marginal sinus-observations in children with Vein of Galen malformation. Neuroradiology. 54(12):1375-9, 2012
                                                  6. Pearl M et al: Cerebral venous development in relation to developmental venous anomalies and Vein of Galen aneurysmal malformations. Semin Ultrasound CT MR. 32(3):252-63, 2011
                                                  7. Karam O et al: VGAM induced high-flow congestive heart failure responsive to PGE1 infusion. Int J Cardiol. 132(2):e60-2, 2009
                                                  8. Abend NS et al: Vein of galen aneurysmal malformation with deep venous communication and subarachnoid hemorrhage. J Child Neurol. 23(4):441-6, 2008
                                                  9. Germanwala AV et al: Ethylenevinylalcohol copolymer (Onyx-18) used in endovascular treatment of vein of Galen malformation. Childs Nerv Syst. 24(1):135-8, 2008
                                                  10. Iizuka Y et al: Endovascular remodeling technique for vein of Galen aneurysmal malformations--angiographic confirmation of a connection between the median prosencephalic vein and the deep venous system. J Neurosurg Pediatr. 1(1):75-8, 2008
                                                  11. Jankowitz BT et al: Treatment of pediatric intracranial vascular malformations using Onyx-18. J Neurosurg Pediatr. 2(3):171-6, 2008
                                                  12. Muquit S et al: Vein of Galen malformation presenting in adulthood. Br J Neurosurg. 22(5):692-4, 2008
                                                  13. Alvarez H et al: Vein of galen aneurysmal malformations. Neuroimaging Clin N Am. 17(2):189-206, 2007
                                                  14. Patel N et al: Systemic haemodynamics in infants with vein of Galen malformation: assessment and basis for therapy. J Perinatol. 27(7):460-3, 2007
                                                  15. Gailloud P et al: Diagnosis and management of vein of galen aneurysmal malformations. J Perinatol. 25(8):542-51, 2005
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Vein of Galen (VofG), vein of Galen aneurysmal malformation (VGAM), median prosencephalic vein (MPV) of Markowski
                                                            • Synonyms

                                                              • Vein of Galen "aneurysm," galenic varix
                                                            • Definitions

                                                              • Arteriovenous fistula (AVF) between pericallosal/deep choroidal arteries and embryonic MPV (precursor of VofG)
                                                              • High flow through MPV prevents formation of vein of Galen; VGAM is misnomer

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Echocardiographic Findings

                                                                        • Angiographic Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Staging, Grading, & Classification

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Image Interpretation Pearls

                                                                                                • Reporting Tips

                                                                                                  Selected References

                                                                                                  1. Pop R et al: Flow control using Scepter(TM) balloons for Onyx embolization of a vein of Galen aneurysmal malformation. Childs Nerv Syst. 31(1):135-40, 2015
                                                                                                  2. Mortazavi MM et al: Vein of Galen aneurysmal malformations: critical analysis of the literature with proposal of a new classification system. J Neurosurg Pediatr. 12(3):293-306, 2013
                                                                                                  3. Berenstein A et al: Vein of Galen malformations in neonates: new management paradigms for improving outcomes. Neurosurgery. 70(5):1207-13; discussion 1213-4, 2012
                                                                                                  4. Jagadeesan BD et al: Susceptibility-weighted imaging: a new tool in the diagnosis and evaluation of abnormalities of the vein of Galen in children. AJNR Am J Neuroradiol. 33(9):1747-51, 2012
                                                                                                  5. Meila D et al: The persistent primitive marginal sinus-observations in children with Vein of Galen malformation. Neuroradiology. 54(12):1375-9, 2012
                                                                                                  6. Pearl M et al: Cerebral venous development in relation to developmental venous anomalies and Vein of Galen aneurysmal malformations. Semin Ultrasound CT MR. 32(3):252-63, 2011
                                                                                                  7. Karam O et al: VGAM induced high-flow congestive heart failure responsive to PGE1 infusion. Int J Cardiol. 132(2):e60-2, 2009
                                                                                                  8. Abend NS et al: Vein of galen aneurysmal malformation with deep venous communication and subarachnoid hemorrhage. J Child Neurol. 23(4):441-6, 2008
                                                                                                  9. Germanwala AV et al: Ethylenevinylalcohol copolymer (Onyx-18) used in endovascular treatment of vein of Galen malformation. Childs Nerv Syst. 24(1):135-8, 2008
                                                                                                  10. Iizuka Y et al: Endovascular remodeling technique for vein of Galen aneurysmal malformations--angiographic confirmation of a connection between the median prosencephalic vein and the deep venous system. J Neurosurg Pediatr. 1(1):75-8, 2008
                                                                                                  11. Jankowitz BT et al: Treatment of pediatric intracranial vascular malformations using Onyx-18. J Neurosurg Pediatr. 2(3):171-6, 2008
                                                                                                  12. Muquit S et al: Vein of Galen malformation presenting in adulthood. Br J Neurosurg. 22(5):692-4, 2008
                                                                                                  13. Alvarez H et al: Vein of galen aneurysmal malformations. Neuroimaging Clin N Am. 17(2):189-206, 2007
                                                                                                  14. Patel N et al: Systemic haemodynamics in infants with vein of Galen malformation: assessment and basis for therapy. J Perinatol. 27(7):460-3, 2007
                                                                                                  15. Gailloud P et al: Diagnosis and management of vein of galen aneurysmal malformations. J Perinatol. 25(8):542-51, 2005