Aneurysms of the vein of Galen in children: CT and angiographic correlations.

An aneurysm of the vein of Galen is a rare midline arteriovenous malformation. The clinical signs and the prognosis strictly depend on age of presentation and on the amount of blood shunted into the malformation. In the newborn, cardiac failure is the most common presenting sign. In order children hydrocephalus, headache, focal neurological signs and subarachnoid bleeding may be the reason for admission. At the Hospital for Sick Children six patients with an aneurysm of the vein of Galen were studied by angiography and CT. Four of them were newborn in cardiac failure. Angiography was essential for the accurate demonstration of all the feeding vessels to the malformation and their exact location. Computed tomography also added useful information on associated hydrocephalus and ischemic brain damage. The dilated vein of Galen, straight sinus and torcular were clearly seen. Abnormal arterial vessels feeding the malformation were also recognized.