Vein of galen aneurysmal malformation with deep venous communication and subarachnoid hemorrhage.
A previously healthy 2-year-old boy presented with the acute onset of left middle cerebral artery syndrome. Evaluation revealed subarachnoid hemorrhage and a vein of Galen aneurysmal malformation with angiographic reflux into the deep venous system. Analysis of the angioarchitecture of the lesion demonstrated the basis of the hemorrhage to be reflux into cortical veins. The case supports and underscores the clinical relevance of recent reports indicating that the venous drainage of a vein of Galen aneurysmal malformation may communicate with the normal deep venous system. Such a communication implies that endovascular or surgical obliteration of the venous side of a vein of Galen aneurysmal malformation may impair normal venous drainage, potentially resulting in a venous infract or hemorrhage.
Abend
Nicholas S
NS
Division of Neurology, The Children's Hospital of Philadelphia, Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
Ichord
Rebecca
R
Aijun Zhang
Hurst
Robert
R
D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D002675:Child, Preschool; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000473:pathology