Prenatal diagnosi of galen vein aneurysmal malformation: A case report

Aneurysm of Galen vein is a congenital malformation diagnosed rarely representing less than 1% of cerebral arteriovenous malformations. Today with the advances in high resolution ultrasonography and color Doppler imaging, prenatal diagnosis is achieved easily. The perinatal prognosis seems to be invariably compromised when signs of cardiac decompensation develop prenatally. On the other hand fetuses with normal velocity waveforms and a low extent of the systemic shunt have a good extrauterine adaptation. in addition novel intravascular embolization techniques, placement of intraaneurysmal balloon and vascular microcoils provided a precise improvement in perinatal prognosis postnatally. We report a case of Galen vein aneurysm detected at 33 weeks of pregnancy by color Doppler ultrasonography. Routine ultrasonographic examination demonstraled a large midline supratentorial cystic lesion associated with cardiomegaly first. A markedly turbulent flow pattern within the cerebral lesion detected by color Doppler ultrasonography revealed the diagnosis of Galen vein aneurysm. Fetal demise occurred at 35 weeks of pregnancy. Autopsy findings confirmed the diagnosis. We suggest that color Doppler ultrasonography may assist in the diagnosis of Galen vein aneurysm and precisely delineate the complicated corresponding vasculature. This may guide the appropriate management and predict the fetal outcome accurately.