Fetal Vein of Galen Aneurysmal Malformation (VGAM) Detected at 36 Weeks: Review of Literature and Case Report

Abstract

Vein of Galen malformation is a rare intracranial vascular lesion most often concomitant with poor prognosis when associated with high-output cardiac failure. We present a case that was diagnosed late in the third trimester, but due to the limitations in our local settings, immediate operative intervention could not be done. A 24-year-old primigravida was sent for a routine 36-week obstetric ultrasound scan (USS), which revealed a midline cystic structure with mosaic color signals on a duplex Doppler USS within the fetal head. The unavailability of fetal magnetic resonance venography (MRV) delayed confirmation until the postnatal period. An MRV done on the second day of delivery showed a dilated, tortuous midline structure in the region of the vein of Galen, which confirmed the findings. Echocardiography revealed multiple cardiac lesions. Although, both antenatally and at birth, there was no cardiac failure, the baby died on the seventh day of life from possible cardiac compromise.