Prenatal diagnosis and management of the aneurysm of the vein of galen. A case report

Amaç

"Aneurysm of the vein of Galen" encompasses a range of different midline arteriovenous fistula malformations. Prenatal Doppler sonography may contribute to the differential diagnosis of fetal cystic lesions of various origins. We describe a case of aneurysm of the vein of Galen which was detected as a cerebral cystic lession prenatally. Diagnosis was incomplete as Doppler sonography has not been used.

Olgu

A cystic cerebral lession, dilated third ventricle and cardiomegaly were identified by ultrasonography in a fetus at 32 weeks gestation. A 4600g male infant was delivered at 41 weeks gestation with cesarean section because of cephalopelvic dysproportion. Cranial Doppler sonography revealed dilated third ventricle and aneurysm of the vein of Galen at the midline posterior to the third ventricle. Cranial magnetic resonance imaging showed severe neural parenchymal destruction in both hemispheres, additionally. Echocardiography revealed pathologies secondary to increased hemodynamic load. Postnatal management included transarterial embolization of the vessels feeding the aneurysm after angiography, by radiologists. The infant has grown appropiately at four months of age with no problems.

Sonuç

Prenatal diagnosis of aneurysm of the vein of Galen is possible with real-time ultrasonography, pulsed wave Doppler, color-velocity imaging and magnetic resonance imaging. Identification of this condition should prompt close follow-up of the pregnancy. Careful obstetric management and early postnatal intervention may lead to a favorable outcome. This case demonstrates that Doppler sonography is crucial for evaluation of fetal cystic lessions in the brain. 

Anahtar Kelimeler

Aneurysm of the vein of Galen, Prenatal diagnosis, Doppler sonography.

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