Vein of Galen malformation

person in white long sleeve shirt holding black and white round wall decor
  • Aneurysmal dilatation of median prosencephalic vein of Markowski due to arteriovenous fistula that occurs in 6-11 weeks of gestation 
  • 30% of all pediatric vascular malformations
  • M:F = 2:1
  • Most common extra cardiac cause of high output cardiac failure
  • Presents with heart failure or hydrocephalus 
  • Two types: choroidal and mural. Choroidal has feeders from pericallosal, choroidal or thalamoperforating arteries. Mural has few feeders from uni or bilateral collicular or posterior choroidal arteries


Chest radiograph
  • Cardiomegaly
  • Wide mediastinum
  • Plain study: venous pouch slightly hype dense. Wall calcification seen when there is thrombus in the aneurysm. Hydrocephalus, ischemia, parenchymal atrophy
  • CECT: enhancing feeding arteries and veins 
  • CTA: excellent 
  • T1: arterial flow voids. MPV shows flow void  or mixed signal. Intraluminal thrombus appears bright.
  • T2:same as T1
  • MRA: excellent