Vein of Galen malformation in a neonate: A case report and review of endovascular management

Abstract

Vein of Galen malformation (VOGM) is a rare congenital vascular malformation caused by the maldevelopment of its embryonic precursor, the median prosencephalic vein of Markowski. VOGM results in neonatal morbidity and mortality, and premature delivery does not improve the outcome. We report a term female neonate in whom a vein of Galen malformation was diagnosed prenatally at 37 wk of gestation during a growth ultrasound and confirmed by fetal magnetic resonance imaging. Signs of cardiac decompensation were evident in the fetus. Multiple interventional radiology embolizations of the feeding vessels were performed successfully on days 7, 10, 12, 14 and 19. A review of the literature on the endovascular management of neonates with these malformations is presented herein.

Keywords: Vein of Galen malformation; Endovascular therapy; Congenital anomaly; Neonate

Core tip: Vein of Galen malformation (VOGM) is a rare vascular anomaly that may present in the fetus or newborn, and may cause congestive heart failure. Historically, the management of VOGMs was neurosurgical, but outcomes were uniformly poor. Since the introduction of endovascular interventional techniques, the likelihood of a successful treatment is much greater and a cure is potentially achievable. We report herein a term female neonate with a VOGM that was sucessfully treated with multiple endovascular embolizations, and also present a review of the literature on the endovascular management of neonates.