Chisholm C A, Kuller J A, Katz V L, McCoy M C
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
Am J Perinatol. 1996 Nov;13(8):503-6. doi: 10.1055/s-2007-994437.
An aneurysm of the vein of Galen is a rare arteriovenous malformation of the central nervous system. Fetal manifestations have included nonimmune hydrops, hydrocephalus, and intracranial hemorrhage. This anomaly may be diagnosed prenatally by several imaging modalities. A cystic cranial mass was identified by ultrasound in a fetus at 30 weeks gestation. Both pulsed-wave Doppler and color-velocity imaging studies suggested aneurysm of the vein of Galen was the most likely diagnosis. The fetus demonstrated no evidence of hydrops on serial ultrasound examinations. A 2430 g female infant was delivered vaginally at 35 weeks gestation. Postnatal management included transarterial embolization of the vessels feeding the aneurysm with craniectomy, an intra-aneurysmal balloon, and vascular microcoils. Hydrocephalus developed and a ventriculo-peritoneal shunt was placed. The infant has grown appropriately in the first year of life. An aneurysm of the vein of Galen may be diagnosed prenatally by real-time ultrasound, pulsed-wave Doppler, color-velocity imaging, or magnetic resonance imaging. The presence of this malformation should prompt close follow-up for the remainder of the pregnancy. Careful obstetric management and early postnatal intervention may lead to a favorable outcome.
大脑大静脉动脉瘤是一种罕见的中枢神经系统动静脉畸形。胎儿期表现包括非免疫性水肿、脑积水和颅内出血。这种异常可通过多种成像方式在产前诊断。在一名妊娠30周的胎儿中，超声检查发现一个囊性颅骨肿块。脉冲波多普勒和彩色速度成像研究均提示大脑大静脉动脉瘤是最可能的诊断。在系列超声检查中，该胎儿未显示水肿迹象。一名体重2430克的女婴在妊娠35周时经阴道分娩。产后治疗包括通过开颅术、动脉瘤内球囊和血管微线圈对供应动脉瘤的血管进行经动脉栓塞。患儿出现脑积水并放置了脑室-腹腔分流管。该婴儿在出生后的第一年生长正常。大脑大静脉动脉瘤可通过实时超声、脉冲波多普勒、彩色速度成像或磁共振成像在产前诊断。发现这种畸形后，应在妊娠剩余时间内密切随访。精心的产科管理和早期产后干预可能会带来良好的结果。
