Imaging Characteristics of Dural Arteriovenous Fistulas Involving the Vein of Galen: A Comprehensive Review

Abstract

Vein of Galen aneurysmal malformation (VGAM) is a rare angiopathy, which most commonly presents in infancy. Although very rare, it is associated with high morbidity and mortality rates. In order to minimize such morbid rates, a prompt diagnosis followed by a timely initiation of management is crucial. Multiple antenatal and postnatal imaging techniques for the diagnosis have been described and discussed in the literature. However, to our knowledge, a comprehensive review exploring such a list of imaging options for VGAM has never been established. We aim to review the diagnostic tools to aid in better understanding of the investigative modalities physicians may choose from when treating patients with a VGAM.

Arteriovenous Cerebral High Flow Shunts in Children: From Genotype to Phenotype

“…For patient 3, the shunt is located in the choroidal fissure and drains secondarily into the vein of Galen, and is likely a choroidal fistula. In a further case series on dural arteriovenous shunts ( 22 ), the authors specified in their Figure 3 that the vein of Galen is dilated; however, it seems very probable that the torcular is dilated while the vein of Galen itself is not visible. All these example case series have an abnormal anatomy in common, directly or indirectly implicating the Galen vein or nearby dilated veins.…”

Galenic dural arteriovenous fistula in neurofibromatosis type 1 treated with Onyx

“…They represent 10-15% of cerebrovascular malformations, and most commonly develop in the region of the transverse and sigmoid sinuses. 1 The exact mechanism of development of such DAVF is unclear, and the theories are controversial, with the most accepted being the pathological recanalisation of a thrombosed sinus. Galenic DAVFs are rare and are a heterogeneous group defined by drainage into the deep venous system at various sites and represent approximately 23% of all tentorial DAVFs, which is most frequently associated with aggressive clinical behaviour, presenting the clinician with diagnostic and therapeutic challenges.…”

“…2 The term GDAVF is sometimes confused with vein of Galen malformations (VGMs) or vein of Galen aneurysmal dilatation (VGAD). 1,3,4 VGMs are direct arteriovenous shunts in the subarachnoid space of the velum interpositum cistern and quadrigeminal cistern, supplied by the choroidal and quadrigeminal arteries and drained by the dilated median prosencephalic vein of Markowski, the embryonic precursor of the vein of Galen. VGAD indicates the dilatation of the 'true' (embryologically matured) vein of Galen by vascular lesions, including pial or dural arteriovenous malformation.…”

Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings

“…Moreover, cross-sectional imaging can allow precise anatomic localization of the fistula point, feeding arteries, venous sac, and relationship with surrounding structures. This information is valuable for both diagnosis and treatment planning [ 3 , 4 ]. Here we report a case of a PAVF associated with intraventricular giant venous varices and vein of Galen dilatation in a 33-year-old female presenting with new-onset seizures.…”