Vein of Galen Malformation: A Case Report on a Complex Pediatric Presentation

A BSTRACT Vein of Galen malformation (VOGM) is a rare congenital vascular anomaly characterized by abnormal arteriovenous shunting within the cerebral circulation. The incidence is estimated at 1 in 10,000 to 1 in 25,000 live births. A five-year-old boy presented with unconsciousness, easy fatigability, and breathlessness. Prenatal ultrasonography was not performed due to financial constraints. Magnetic resonance imaging (MRI) revealed VOGM, acute intracranial hemorrhage, hydrocephalus, and complex vascular malformation at the cervical cord. Echocardiography showed high-output cardiac failure. Medical management was initiated, but the patient died after an MRI scan. VOGM originates from deviant arteriovenous fistulas affecting cerebral circulation. Hemodynamic alterations lead to heart failure and hydrocephalus. Different types of VOGM exist, with varied clinical presentations. Timely diagnosis and treatment, typically between four and five years, are crucial for favorable outcomes. Endovascular procedures show promise, but transvenous approaches carry risks.