Normal galenic drainage of the deep cerebral venous system in two cases of vein of Galen aneurysmal malformation.
BACKGROUND
Vein of Galen aneurysmal malformations (VGAM) are assumed to be related to the persistence of the embryonic median prosencephalic vein of Markowski, which does not involute in cases of VGAM and becomes the venous collector of the shunt, characteristic of the malformation. The arterial feeders of VGAMs are all primitive meningeal arteries present during the embryonic period of the constitution of the malformation. It has also been assumed that the internal cerebral veins were absent in patients presenting with VGAM. There is no clear evidence indicating, however, that the deep venous structures cannot develop normally.


METHODS
We report on two cases of VGAM in which superselective retrograde transvenous catheterization and MRI demonstrated that normal internal cerebral veins were draining into the aneurysmal vein of Galen.


CONCLUSIONS
It is conceivable that, as in our patients, this drainage pattern is only angiographically detectable via selective retrograde transvenous drainage. The possibility of such normal deep galenic venous drainage must be considered in VGAM management, as it may imply occurrence of adverse effects when the malformation is occluded on the venous side.
Levrier
O
O
Service de Neuroradiologie, CHU Timone, Boulevard Jean Moulin, 13385 Marseille Cedex 5, France. olevrier@mail.ap-hm.fr
Gailloud
P H
PH
Souei
M
M
Manera
L
L
Brunel
H
H
Raybaud
C
C
D000328:Adult; D002533:Cerebral Angiography / Q000379:methods; D002550:Cerebral Veins; D002648:Child; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery; D002538:Intracranial Arteriovenous Malformations / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods