The aneurysmal malformation of the vein of Galen is a rare condition, corresponding to less than 1% of intracranial vascular malformations. It is a disease affecting mainly newborns and small children. We are reporting the case of an 11-year-old teenager who presented consciousness disorders associated to generalized convulsive seizures. The cerebral CT scan supplemented by an angioscanner, revealed an important expansive process in the pineal region, confirming the diagnosis of an aneurysmal malformation of the Galen's ampulla with upstream obstructive hydrocephalus. The child benefited from a ventriculo-peritoneal shunt with favorable immediate operative sequels. His death occurred at home two months after surgery over the course of a convulsive seizure with post critical coma.

Highlights Recurrent tubercular brain abscess is a rare pathology in immunocompetent children. Recurrence is possible despite a well-managed treatment such as surgery and anti-tuberculosis therapy. Early management and careful monitoring are important. The addition of corticosteroid therapy and readjustment of the dose of anti-tuberculosis drugs are necessary to achieve a cure. Our treatment was based on several punctures of the abscess associated with a shunt, a readjustment of doses of antituberculosis drugs and additional corticosteroid therapy which led to a clinical improvement.

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