Case report: in utero diagnosis of a vein of Galen aneurysm using colour flow Doppler

Prenatal diagnosis of an aneurysm of the vein of galen by three-dimensional power and color Doppler ultrasonography

Aneurism of the vein of Galen is a complex arteriovenous malformation which is of multiply communications between of the vein of Galen and the cerebral arteries. It represents less than 1% of the cerebral arteriovenous malformations. Few cases using three-dimensional (3D) power and color Doppler ultrasound have been reported in the literature. We present a case of an aneurysm of the vein of Galen diagnosed at 25th week of pregnancy. We demonstrate the main findings of 3D power and color Doppler ultrasonography in this anomaly. A 36-year-old pregnant woman, gravida 3, para 2 was referred to our institution because of a midline cystic mass diagnosed in a previous ultrasonography undertaken at 24 weeks' gestation. The ultrasonographic finding consisted of a male fetus with a midline cystic mass, with positive flow detection by color Doppler and ventriculomegaly due to the compressive effects of the malformation. The 3D color and power Doppler ultrasonography allowed us to reconstruct the architecture of the vascular malformation, and it showed the spatial relationships of aneurysm of the vein of Galen with the other structures of the brain. Pregnancy was interrupted at 29 weeks' gestation because of presence of cardiomegaly. A male newborn survived for 36 hours only. The 3D ultrasound can be used as advent image technique in prenatal diagnosis of aneurysm of the vein of Galen.

[Antenatal diagnosis and management of vein of Galen aneurysm: review illustrated by a case report]

Vein of Galen aneurysm is a rare vascular congenital malformation. We report an antenatal diagnosis with duplex Doppler at 26 weeks gestation. Magnetic resonance imaging was used before and after delivery in order to determine neurological prognosis. The neonatal prognosis is poor if fetal cardiac insufficiency or cerebral lesions are present antenatally. Premature delivery does not improve the neonatal outcome. When the aneurysm is not life threatening, embolization of the malformation is at best delayed five months after birth.

Isolated cardiomegaly in the second trimester as an early sign of fetal hydrops due to intracranial arteriovenous malformation

We report the case of a 27-year-old pregnant woman in whom isolated mild fetal cardiomegaly, diagnosed prenatally on sonographic examination at 22 weeks' menstrual age, was the first sign of development of an arteriovenous malformation of the vein of Galen. The arteriovenous malformation was visualized on sonographic examination at 29 weeks' menstrual age; prenatal MRI at 32 weeks confirmed the diagnosis. At 34 weeks' menstrual age, repeat sonographic examination demonstrated polyhydramnios, cardiomegaly, and generalized hydrops with ascites and pleural effusion. After vaginal delivery, the male neonate died of respiratory distress. We present the findings of prenatal gray-scale, color Doppler, and power Doppler sonography; MRI; and postmortem examination.