title: Clinics in diagnostic imaging (132). Vein of Galen malformation.
abstract: A two-day-old, full-term male infant was admitted to the neonatal intensive care unit with heart failure. He was found to be non-dysmorphic, with no clinical evidence of sepsis. Physical examination was significant for hepatomegaly, active precordium, pansystolic murmur and hypotension requiring ionotropic support. A cranial bruit was detected on auscultation. Chest radiography revealed cardiomegaly and pulmonary oedema due to heart failure. Electrocardiogram and two-dimensional echocardiography were normal. Magnetic resonance imaging of the brain showed a large vein of Galen malformation, extensive cerebral ischaemia and multiple cerebral infarcts. This case illustrates the importance of auscultation of the cranium to rule out vein of Galen malformation, a potential cause of high-output cardiac failure in neonates in the absence of other common causes of heart failure.
authors.affiliation: Department of Paediatrics/Neonatology, University of Calgary, Calgary, AB T2N 2T9, Canada. abhay.lodha@albertahealthservices.ca
authors.forename: A
authors.initials: A
authors.lastname: Lodha
authors.forename: M
authors.initials: M
authors.lastname: Kamaluddeen
authors.forename: A
authors.initials: A
authors.lastname: Akierman
authors.forename: M
authors.initials: M
authors.lastname: Shroff
mesh_terms: D001314:Auscultation; D006332:Cardiomegaly / Q000175:diagnosis* / Q000209:etiology; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D018810:Magnetic Resonance Angiography; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology; D054080:Vein of Galen Malformations / Q000150:complications / Q000175:diagnosis*