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- Title
Fetal isolated vein of Galen aneurysmal malformation with spontaneous complete regression - a rare occurrence.
- Authors
Dinu, Marina; Șorop-Florea, Maria; Drăgușin, Roxana-Cristina; Gheonea, Ioana-Andreea; Diţă, Florentina; Tudorache, Ștefania; Cismaru-Stăncioi, Andreea-Florentina
- Abstract
Vein of Galen aneurysmal malformation (VGAM) is a rare intracranial vascular malformation, commonly diagnosed using ultrasound in the third trimester of pregnancy. There is a 2-3:1 male predominance. The prenatal diagnosis enhances appropriate perinatal management. If the prenatal diagnosis is missed, VGAM is reported to be fatal in many cases, due to cardiac and neurological complications. A 24-year-old pregnant woman was referred to our tertiary prenatal diagnosis unit (University of Medicine and Pharmacy of Craiova, County Emergency Clinical Hospital of Craiova) for vascular cerebral malformation suspicion. We confirmed a turbulent arterial and venous flow using the color Doppler technique, within an anechoic structure, located in the midline of the posterior part of the third ventricle. The fetus did not develop signs of hydrops or cardiac failure in the prenatal period. The magnetic resonance imaging (MRI) was performed at 36 weeks of amenorrhea, to confirm the sonographic findings and to better predict the postnatal outcome, in the Radiology and Imaging Department of our university. The fetus (female, Apgar score 9, weighing 2720 grams) was delivered by caesarean section, at 37 gestational weeks. The neonatal period was complicated by pulmonary hypertension and mild cardiac events. The child evolved spontaneously favorably. At 32 months, the MRI showed normal intracranial vasculature. Currently, at 5 years of age, she has a completely normal neurologic development. In the last 15 years, the prenatal diagnosis of VGAM has been facilitated by the use of color Doppler mode, which is crucial for differentiating this malformation from midline cystic lesions of the fetal brain (being the only lesion that accurately displays blood flow within it). Fetal MRI may play an important role in customizing perinatal and long-term management. To our knowledge, this is the first case ever reported having a prenatal diagnosis and a spontaneous complete regression.
- Subjects
CRAIOVA (Romania); GALEN, 129-ca. 216; CEREBRAL arteriovenous malformations; SPONTANEOUS cancer regression; THIRD trimester of pregnancy; MAGNETIC resonance imaging; PRENATAL diagnosis; HYDROPS fetalis; HUMAN abnormalities
- Publication
Obstetrică şi Ginecologie, 2023, Vol 71, Issue 4, p179
- ISSN
1220-5532
- Publication type
Article