A Severe Case of Aneurysmal Malformation of the Vein of Galen, Cardiac Failure and Intrauterine Fetal Death

Aneurism of the vein of Galen is a rare congenital anomaly, where complex arteriovenous malformation are identified between multiple choroidal arteries and the median prosencephalic vein of Markowski, which is a precursor of the vein of Galen, with subsequent aneurysmal enlargement of the respective arteriovenous system. The congenital malformation develops during week 6 to 11 of fetal development. Infants often die from high-output congestive heart failure. We present a case of a 40 years old patient, presented the first time at hospital at 28 weeks of gestation for lower perception of fetal movements. The patient was referred to our Prenatal Diagnosis Unit for a suspected cardiac malformation. We diagnosed cardiomegaly along vein of Galen aneurysmal malformation (VGAM) with severe cardiac failure, ascites, and critical fetal distress. Fetal demise was noted 24 hours later, during the corticosteroid procedures for fetal maturation. A stillborn weighting 2000g with a severe hydropic aspect was born after labor induction. Autopsy was performed following injection of colored gelatin in carotid vessels. The aneurysmal defect was evident in the vein of Galen and straight sinus. We also found the transverse, sagittal and the occipital sinus seriously dilated. We could not highlight the communication with the middle cerebral artery, because of the degradation of the cerebral tissue, despite an optimal preparation