VEIN OF GALEN MALFORMATION

1. VEIN OF GALEN MALFORMATION

2. • PRESENTATION
• AS CCF IN THE FIRST WEEK OF LIFE AND HAVE
POOR PROGNOSIS

3. VEIN OF GALEN
• The congenital malformation develops during
weeks 6-11 of fetal development as a
persistent embryonic prosencephalic vein of
Markowski thus, VGAM is actually a
misnomer.
• The vein of Markowski actually drains into the
vein of Galen.

4. • It can produce hydrocephalus if it obstructs
the sylvian aqueduct

7. • True VOG ARE FED FROM
– ANTERIOR CHOROIDAL
– MEDIAL AND LATERAL CHOROIDAL
– MESENCEPHALIC
– PERICALLOSAL VESSELS

8. TYPES OF VEIN OF GALEN
MALFORMATION
• PURE INTERNAL FISTULA
• ‘
• FISTULA BETWEEN THALAMOPERFORATORS
AND VEIN OF GALEN
• MIXED FORM(MOST COMMON TYPE)
• PLEXIFORM TYPE

9. CLINICAL FEATURES
• RESPIRATORY DISTRESS
• REFUSAL OF FEED
• HYDROCEPHALUS – SUNSET SIGN
• CYANOSIS
• SEIZURES

10. CLASSIFICATION
• LASJAUNIAS CLASSIFICATION
– CHOROIDAL
– MURAL

11. CLASSIFICATION
• YASARGILL CLASSIFICATION
• TYPE I – PURE CISTERNAL CONNECTION
BETWEEN VOG AND PERICALLOSAL /
POSTERIOR CEREBRAL
• TYPE II - MULTIPLE FISTULUS CONNECTION
BETWEEN THALAMOPERFORATORS AND VOG

12. • TYPE III
– HIGH FLOW MIXED TYPE I AND TYPE II
TYPE IV
PARENCHYMAL AVM WITH DRAINAGE

13. PROGNOSIS
• POOR

14. TREATMENT
• OPTION COMPRISES OF
– EMBOLIZATION
– RESECTION
– RADIOSURGERY