Vein of Galen aneurysmal malformation (VGAM), galenic varix
Definitions
High-flow arteriovenous (AV) fistula between deep choroidal arteries & median prosencephalic vein (MPV) of Markowski
Not actually aneurysm of true vein of Galen, which fails to form because of fistula
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
D'Amico A et al: Outcome of fetal vein Galen aneurysmal malformations: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 1-6, 2021
Arko L et al: Fetal and neonatal MRI predictors of aggressive early clinical course in vein of Galen malformation. AJNR Am J Neuroradiol. 41(6):1105-11, 2020
Li TG et al: Diagnosis of foetal vein of galen aneurysmal malformation by ultrasound combined with magnetic resonance imaging: a case series. BMC Med Imaging. 20(1):63, 2020
Berenstein A et al: Vein of Galen aneurysmal malformation: advances in management and endovascular treatment. Neurosurgery. 84(2):469-78, 2019
Agarwal H et al: Vein of Galen aneurysmal malformation-clinical and angiographic spectrum with management perspective: an institutional experience. J Neurointerv Surg. 9(2):159-64, 2017
Yan J et al: The natural progression of VGAMs and the need for urgent medical attention: a systematic review and meta-analysis. J Neurointerv Surg. 9(6):564-70, 2017
Saliou G et al: Decreased duperior sagittal sinus diameter and jugular bulb narrowing are associated with poor clinical outcome in vein of Galen arteriovenous malformation. AJNR Am J Neuroradiol. 37(7):1354-8, 2016
Chow ML et al: Radiological and clinical features of vein of Galen malformations. J Neurointerv Surg. 7(6):443-8, 2015
Meila D et al: Cranial Doppler ultrasound in vein of Galen malformation. Neuroradiology. 57(2):211-9, 2015
Zaidi HA et al: Multimodal treatment strategies for complex pediatric cerebral arteriovenous fistulas: contemporary case series at Barrow Neurological Institute. J Neurosurg Pediatr. 1-10, 2015
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
Deloison B et al: Hidden mortality of prenatally diagnosed vein of Galen aneurysmal malformation: retrospective study and review of the literature. Ultrasound Obstet Gynecol. 40(6):652-8, 2012
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
Recinos PF et al: Vein of Galen malformations: epidemiology, clinical presentations, management. Neurosurg Clin N Am. 23(1):165-77, 2012
Suazo L et al: Measurement of blood flow in arteriovenous malformations before and after embolization using arterial spin labeling. Interv Neuroradiol. 18(1):42-8, 2012
Jea A et al: The high risks of ventriculoperitoneal shunt procedures for hydrocephalus associated with vein of Galen malformations in childhood: case report and literature review. Pediatr Neurosurg. 46(2):141-5, 2010
Pearl M et al: Endovascular management of vein of Galen aneurysmal malformations. Influence of the normal venous drainage on the choice of a treatment strategy. Childs Nerv Syst. 26(10):1367-79, 2010
Lasjaunias PL et al: The management of vein of Galen aneurysmal malformations. Neurosurgery. 59(5 Suppl 3):S184-94; discussion S3-13, 2006
Jones BV et al: Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up. AJNR Am J Neuroradiol. 23(10):1717-24, 2002
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KEY FACTS
Terminology
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TERMINOLOGY
Synonyms
Vein of Galen aneurysmal malformation (VGAM), galenic varix
Definitions
High-flow arteriovenous (AV) fistula between deep choroidal arteries & median prosencephalic vein (MPV) of Markowski
Not actually aneurysm of true vein of Galen, which fails to form because of fistula
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
D'Amico A et al: Outcome of fetal vein Galen aneurysmal malformations: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 1-6, 2021
Arko L et al: Fetal and neonatal MRI predictors of aggressive early clinical course in vein of Galen malformation. AJNR Am J Neuroradiol. 41(6):1105-11, 2020
Li TG et al: Diagnosis of foetal vein of galen aneurysmal malformation by ultrasound combined with magnetic resonance imaging: a case series. BMC Med Imaging. 20(1):63, 2020
Berenstein A et al: Vein of Galen aneurysmal malformation: advances in management and endovascular treatment. Neurosurgery. 84(2):469-78, 2019
Agarwal H et al: Vein of Galen aneurysmal malformation-clinical and angiographic spectrum with management perspective: an institutional experience. J Neurointerv Surg. 9(2):159-64, 2017
Yan J et al: The natural progression of VGAMs and the need for urgent medical attention: a systematic review and meta-analysis. J Neurointerv Surg. 9(6):564-70, 2017
Saliou G et al: Decreased duperior sagittal sinus diameter and jugular bulb narrowing are associated with poor clinical outcome in vein of Galen arteriovenous malformation. AJNR Am J Neuroradiol. 37(7):1354-8, 2016
Chow ML et al: Radiological and clinical features of vein of Galen malformations. J Neurointerv Surg. 7(6):443-8, 2015
Meila D et al: Cranial Doppler ultrasound in vein of Galen malformation. Neuroradiology. 57(2):211-9, 2015
Zaidi HA et al: Multimodal treatment strategies for complex pediatric cerebral arteriovenous fistulas: contemporary case series at Barrow Neurological Institute. J Neurosurg Pediatr. 1-10, 2015
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
Deloison B et al: Hidden mortality of prenatally diagnosed vein of Galen aneurysmal malformation: retrospective study and review of the literature. Ultrasound Obstet Gynecol. 40(6):652-8, 2012
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
Recinos PF et al: Vein of Galen malformations: epidemiology, clinical presentations, management. Neurosurg Clin N Am. 23(1):165-77, 2012
Suazo L et al: Measurement of blood flow in arteriovenous malformations before and after embolization using arterial spin labeling. Interv Neuroradiol. 18(1):42-8, 2012
Jea A et al: The high risks of ventriculoperitoneal shunt procedures for hydrocephalus associated with vein of Galen malformations in childhood: case report and literature review. Pediatr Neurosurg. 46(2):141-5, 2010
Pearl M et al: Endovascular management of vein of Galen aneurysmal malformations. Influence of the normal venous drainage on the choice of a treatment strategy. Childs Nerv Syst. 26(10):1367-79, 2010
Lasjaunias PL et al: The management of vein of Galen aneurysmal malformations. Neurosurgery. 59(5 Suppl 3):S184-94; discussion S3-13, 2006
Jones BV et al: Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up. AJNR Am J Neuroradiol. 23(10):1717-24, 2002
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