Vein of Galen Malformation

  • Etiology: Failure of Vein of Galen + straight sinus development
  • Imaging:
    — Choroidal type – multiple fistulae from posterior choroidal artery + adjacent midbrain thalamoperforating arteries to median prosencephalic vein (of Markowski) = pial arteriovenous malformation with deep venous drainage
    — Mural type – single fistula in wall of median prosencephalic vein (of Markowski) = direct arteriovenous fistula
  • Clinical: presentation varies with age – choroidal type presents in neonates with high output CHF, mural type presents in children with hydrocephalus, in adults with subarachnoid hemorrhage

Cases of Vein of Galen Malformation

US of Vein of Galen malformation
Coronal and sagittal US of the brain shows a high flow vascular structure in the region of the median prosencephalic vein. A bruit was subsequently noted in this area.