Article
Aneurysm of the vein of Galen
Search Medline for
Authors
Published: | May 4, 2005 |
---|
Outline
Text
Objective
We introduce you the case of a two months and a week age masculine suckling baby who was diagnosed with aneurysm of the great cerebral vein, a central nervous system rare arteriovenous malformation characterized by a high venous flux.
Methods
Clinical study: pregnancy with frequent abortion imminence, new-born in term (9 months) by natural birth, weight of 3200 g, Apgar score 9, height of 50 cm, who indicated the physiologic jaundice, was Anti Hepatitis B and Bacil Calmette-Guerin vaccinated , artificially fed, exposes in the clinic for apnea and perioronasal cyanosis and episodes of gazed look for some seconds, other times for some minutes, time while he doesn't react to any stimuli.
Paraclinical study: It is recommended CT, transcraneous US (bi-dimensional and EcoDoppler), echocardiography, thoracic teleradiography and hemoleukogram.
Results
CT: parenchymatous formation with a density closed to the cerebral parenchyme, situated in the great cerebral vein's tank, with intense contrast connection of intravascular type and with dilated and contrasted vessels especially during the precocious time; increased size of the inferior longitudinal sinus; this hyperdense formation has a globularis aspect and stretches towards the median line predominantly to the right hemisphere. He didn't present any hydrocephaly. Transcraneous US:
• Bi-dimensional: on a transversal section, laterally to the right lateral ventricle, a trans-sonic formation with a posterior confirmation echo (16-17 mm diameter). On the longitudinal section, the described formation is posterior projected to the ventricular system;
• EcoDoppler: vascular pulsatile formation, situated at 3.5 cm depth, with increased flux speed (100 cm/s) with a tortuous aspect, perceptible to the anterior and posterior fontanel level as well as in the occipital foramen level; flux with anteroposterior direction.
Echocardiography: Foramen Ovale permeable, persistent of arterial channel and medium valvular pulmonary stenosis. Thoracic teleradiography: accentuated pulmonary drawing intercleidohilary and bilateral hiliobasal; heart with increased transversal diameter on both inferior arches.
Hemoleucograma presented leucocitosis with thrombocitosis (750000/mm3).
Conclusions
We'll have to decide whether to apply a conservative treatment or to take in consideration a surgical approach or an embolisation depending on the evolution of the patient and the complications that will appear.