Clinics in diagnostic imaging (132) . Vein of Galen malformation
Lodha, A.; Kamaluddeen, M.; Akierman, A.; Shroff, M.
Singapore Medical Journal 51(11): 896-898; Quiz 899
2010
ISSN/ISBN: 0037-5675 PMID: 21140118 Document Number: 647047
A two-day-old, full-term male infant was admitted to the neonatal intensive care unit with heart failure. He was found to be non-dysmorphic, with no clinical evidence of sepsis. Physical examination was significant for hepatomegaly, active precordium, pansystolic murmur and hypotension requiring ionotropic support. A cranial bruit was detected on auscultation. Chest radiography revealed cardiomegaly and pulmonary oedema due to heart failure. Electrocardiogram and two-dimensional echocardiography were normal. Magnetic resonance imaging of the brain showed a large vein of Galen malformation, extensive cerebral ischaemia and multiple cerebral infarcts. This case illustrates the importance of auscultation of the cranium to rule out vein of Galen malformation, a potential cause of high-output cardiac failure in neonates in the absence of other common causes of heart failure.