[Giant arteriovenous malformation of the vein of Galen in a 50 year old man].
True malformations of the vein of Galen are usually diagnosed within the first weeks of life. They represent less than 1 p. 100 of the cerebral arteriovenous malformations. These true malformations are exceptional in adults but should be known as an endovascular treatment could be performed. The most frequent clinical presentation is a severe cardiac failure leading to death. We report a giant arteriovenous malformation of the vein of Galen in a right-handed, 50 year-old man. During childhood, he suffered from a compensated cardiac failure which remained of unknown cause. Neurological examination showed kinetic and static cerebellar syndrome and a Parinaud syndrome. A cerebral MRI scan revealed a giant vascular malformation of the vein of Galen with a normal posterior fossa. The angiography enabled the diagnosis of a true malformation of the vein of Galen in its choroidian form. Its high blood flow entails cardiac failure because of a steal phenomenon. An endovascular treatment was declined because of numerous arterial afferences and the potential risks of peroperative haemorrhage.
Cordonnier
C
C
Service de Neurologie et Pathologie Neurovasculaire (EA291), Hôpital Salengro, CHRU de Lille, 59037 Lille.
Lucas
C
C
Leclerc
X
X
Gauvrit
J Y
JY
Leys
D
D
D002303:Cardiac Output, Low / Q000209:etiology; D002526:Cerebellar Diseases / Q000209:etiology; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000002:abnormalities* / Q000473:pathology; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000473:pathology*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D015835:Ocular Motility Disorders / Q000209:etiology