Images in Anesthesiology  |   September 2016
Vein of Galen Malformation and High-output Cardiac Failure
Author Notes
  • From the Departments of Anesthesiology (A.S., M.M.) and Radiology (T.A.), University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.
  • Address correspondence to Dr. Smith: ashley.smith4@cchmc.org
Article Information
Education / Images in Anesthesiology / Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Pediatric Anesthesia
Images in Anesthesiology   |   September 2016
Vein of Galen Malformation and High-output Cardiac Failure
Anesthesiology 9 2016, Vol.125, 597. doi:10.1097/ALN.0000000000001095
Anesthesiology 9 2016, Vol.125, 597. doi:10.1097/ALN.0000000000001095
A NEWBORN male born at 40 weeks presented with acute tachypnea with feeding. Marked cardiomegaly was noted on chest radiography, and echocardiogram revealed dilated cardiac chambers and systolic failure.
Coronal brain magnetic resonance image consistent with Vein of Galen aneurysmal malformation (VGAM) demonstrates an enlarged midline vascular flow void in the pineal region associated with numerous ectatic vessels in the lateral ventricles and roof of the third ventricle, without evidence of parenchymal hemorrhage, hydrocephalus, or cerebral infarction (fig.). A sagittal left vertebral artery angiogram in the early arterial phase shows rapid arteriovenous shunting from choroidal branches of the right and left posterior cerebral arteries (RPCA and LPCA, respectively) to VGAM. This flow is unloaded into a massively enlarged straight sinus through macrofistulous connections between the choroidal arteries and the wall of the VGAM.
First Page Preview
First page PDF preview
First page PDF preview ×
View Large