Vein of Galen arteriovenous malformation and thrombotic aneurysm
Presentation
Headache and seizure
Patient Data
Rim calcified and marked enlargement of the vein of Galen, filled with dense thrombus, causing supratentorial hydrocephalus. There are multiple dilated tufts of vessels in the basal cisterns. The basilar and both vertebral arteries are prominent. The superior sagittal sinus is dilated posteriorly.
Vein of Galen dilation secondary to high flow parenchymal AVM draining into this vessel. This vein is posteriorly draining into the sagittal sinus and enlarged serpentine arterial feeders arising from posterior circulation adjacent to this lesion are seen. The draining venous sinuses are dilated too. Thrombotic vein of Galen aneurysmal malformation compresses the adjacent sylvan aqueduct and third ventricle. The lateral ventricles are moderately dilated without transependymal edema.
Case Discussion
Adult presentation of thrombotic vein of Galen malformation causing obstructive hydrocephalus is extremely rare.
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