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Journal of Child Neurology
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0883073807308704v1
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Vein of Galen Aneurysmal Malformation With Deep Venous Communication and Subarachnoid Hemorrhage

Nicholas S. Abend, MD

Division of Neurology, the Children's Hospital of Philadelphia, Department of Neurology, University of Pennsylvania Medical Center

Rebecca Ichord, MD

Division of Neurology, the Children's Hospital of Philadelphia, ichord{at}email.chop.edu, Department of Neurology, University of Pennsylvania Medical Center

Aijun Zhang, MD

Department of Neurosurgery, Jinan Central Hospital, Jinan, Shangdong, Peoples Republic of China

Robert Hurst, MD

Department of Radiology University of Pennsylvania Medical Center, Philadelphia, Pennsylvania

A previously healthy 2-year-old boy presented with the acute onset of left middle cerebral artery syndrome. Evaluation revealed subarachnoid hemorrhage and a vein of Galen aneurysmal malformation with angiographic reflux into the deep venous system. Analysis of the angioarchitecture of the lesion demonstrated the basis of the hemorrhage to be reflux into cortical veins. The case supports and underscores the clinical relevance of recent reports indicating that the venous drainage of a vein of Galen aneurysmal malformation may communicate with the normal deep venous system. Such a communication implies that endovascular or surgical obliteration of the venous side of a vein of Galen aneurysmal malformation may impair normal venous drainage, potentially resulting in a venous infract or hemorrhage.

Key Words: vein of Galen aneurysmal malformation • subarachnoid hemorrhage • stroke

This version was published on April 1, 2008

Journal of Child Neurology, Vol. 23, No. 4, 441-446 (2008)
DOI: 10.1177/0883073807308704
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