Aneurysm in the vein of galenus in a newborn: case report

Abstract

Case presentation: M.L.S, 17-year-old, G1P0A0, 35 weeks, referred to the pediatric neurosurgery service for prenatal evaluation and postpartum surgical planning because the fetus has ventricular asymmetry on initial ultrasound examination. Previously the mother had no morphological ultrasound and no proper prenatal care, she was referred to the neurosurgery service but did not attend the appointment, which made it difficult to transfer to an appropriate hospital. After the initial examination, she underwent magnetic resonance imaging, a fetal morphology study and transcranial Doppler ultrasound that showed the presence of a bulky expandable mass compatible with a galenary vein aneurysm. The patient presented pulmonary hypertension that made surgical intervention impossible and died on the 12th day of life due to refractory heart failure. Case discussion: Galen’s vein has a great importance because it drains the central portion of the brain. Prenatal developmental aneurysmal malformation of the gallenary vein begins in the first trimester of gestation, with variable severity and clinical manifestations that can manifest intrauterine with signs of heart failure, hydrocephalus or oligohydramnios. The patient evolved with significant respiratory distress and acute pulmonary edema abs the severity of the condition made it impossible to perform the surgery. Vein of Galen aneurysm constitutes less than 1% of the cases of congenital vascular malformation, its early diagnosis is of great importance, especially since the condition has a high lethality rate. The recognition of this condition based on ultrasound in the prenatal period is a fundamental factor for the diagnosis of the aneurysm and its subsequent referral to a reference center. In this way it is possible to define the best treatment model. Conclusion: It is assumed that if it were diagnosed and referred properly during the intrauterine period, it would be possible to evolve successfully and diminish or nullify the pathophysiological consequences of the newborn aneurysm of Galen’s vein.