PMC3502818_01
Colour duplex sonography: VGAM with mixed venous and arterial flow profiles.
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fig1
The remaining cerebral result presented as normal (Figure 1).
MRI (MPRAGE with contrasting agent): greatly expanded Vein of Galen (arrow).
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fig2
These findings were confirmed by MRI (Figures 2 and 3). 
Angio-MRI (TOF): arterialization of the Vein of Galen and consecutive dilatation (arrow).
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fig3
These findings were confirmed by MRI (Figures 2 and 3). 
Digital subtraction angiography: internal carotid artery lateral and early filling of the Vein of Galen before (a) and after (b).
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fig4
Another fistula to the Vein of Galen was coming from vessels of the vertebral artery (Figures 4 and 5). 
Digital subtraction angiography: vertebral artery ap, with fistula to the Vein of Galen before (a) and after (b).
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fig5
Another fistula to the Vein of Galen was coming from vessels of the vertebral artery (Figures 4 and 5). 
Digital subtraction angiography: Embolisat-Cast (NBCA), (arrow: catheter tip).
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fig6
Thus, at the age of 6 months, a transarterial embolization of 2 afferent vessels was performed using acrylic glue (Figure 6). The dominant blood flow was coming from the right internal carotid artery, fistulous directly to the Vein of Galen.
Colour duplex sonography after first embolization: no cystic mass is visible any more.
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fig7
MRI followup control after the first embolization (T2-weighted): dilated Vein Galen after intervention with NBCA-Cast (arrow).
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fig8
Digital subtraction angiography after second endovascular embolization. (a) Internal carotid artery, a pathological drainage cannot be longer represented (circle). (b) Vertebral artery, small residuum without relevant filling of the Vein of Galen (circle).
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fig9
This intervention followed with 12 months of life successfully with the result of a 95-percent closure of the vascular lesion (Figure 9). The remaining microshunt was identified coming from a subependymal artery, which is impenetrable for an embolization catheter (Figure 9(b)).
MRI follow-up control after the second embolization (T2-weighted): Vein of Galen still patent, but significant decrease in seizure. NBCA-casts in the sack.
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fig10
The venous return was now made by collaterals in the Sinus transversus and Sinus sigmoideus (Figures 10 and 11).
Phase contrast-MRI: no indication of perfusion of the venous aneurysm.
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fig11
The venous return was now made by collaterals in the Sinus transversus and Sinus sigmoideus (Figures 10 and 11).
PMC3502818_02