VASCULAR CYSTIC

INTRACRANIAL

LESION

VASCULAR

• 24-Aneurysm

• 25-Parenchymal Perianeurysmal Cystic

Changes in the Brain

• 26-Vein of Galen malformation

Vein of Galen malformations

(VOGMs)

• The aneurysm of the vein of Galen

represents a rare intracranial

arteriovenous malformation

CT scan in a 3 month old child with vein of Galen malformation a: Plain axial CT

scan of the brain showing a rim of calcification located along the wall of the

venous sac

Fetal MRI imaging of aneurysm of vein of Galen

CT scan with contrast medium. Note the enlarged lateral ventricles and the large well-defined globular mass in the pineal region. Contrast enhancement

MRI; midline sagittal projection. T1-weighted image shows the spheroidal lesion with a

signal void that is typical of a high flow arteriovenous malformation. The aneurysm

causes a mass-efect on the aqueductus of Silvius, the posterior part of the third ventricle

and the splenium of the corpus callosum.

MRI of a thrombosed vein of Galen mlaformation:

: Plain T2 weighted sagittal scan of the

brain revealing the characteristic

location of the lesion

Plain T1 weighted axial scan of the

brain revealing the presence of

thrombus at various st ages within the

venous sac

Lateral MR venogram

Vein of Galen malformation.

T1-

The dilated vein of Galen communicates

with a persistent falcine sinus (arrow).

pericallosal branches (P).

vein of Galen

malformation

neonate

Transcranial color Doppler ultrasonography

aneurysmal dilatation of the median

prosencephalic vein of Markowski (black

arrows).

Two year old Vein of Galen malformation.

Plain radiograph of the skull showing calcification of the wall

of the venous sac of a vein of Galen malformation

Differential diagnosis

midline cystic cerebral lesions • Arachnoid cysts

• Porencephalic cysts

• Choroid plexus cysts

• Choroid papilloma

• Intracranial teratomas

• Congenital dural arteriovenous fistula

Parenchymal Perianeurysmal

Cystic Changes in the Brain

large (2.0-cm-

diameter) right

posterior cerebral

artery aneurysm

(arrow) with an

adjacent cluster of

various sized cysts

(arrowheads).

Parenchymal Perianeurysmal Cystic

Changes in the Brain

T2- perianeurysmal cysts in the left basal ganglia (arrowhead).

Coronal T1+C aneurysm of the left internal

carotid artery Several small cysts

(arrowheads) are seen superior to the

aneurysm(arrow)

Parenchymal Perianeurysmal Cystic

Changes in the Brain

• T1 enhanced multiple small cysts (arrowheads) around the large (1.9-cm-diameter)

aneurysm (arrow) of the right posterior cerebral artery.

Parenchymal Perianeurysmal Cystic

Changes in the Brain

right anterior cerebral artery aneurysm (arrow) as hyperintense. The

adjacent cyst (arrowhead) is unilocular and irregular in shape

Parenchymal Perianeurysmal Cystic

Changes in the Brain

• CT scan shows a giant (4.0-cm-diameter) aneurysm (arrow) with prominent thrombosis and calcifications.

Perianeurysmal cyst (arrowhead) and edema are depicted in the left frontal lobe.

Parenchymal Perianeurysmal Cystic

Changes in the Brain

blood within an arachnoid cyst at the tip of the left temporal lobe with a degree of

ventricular dilatation

Posterior communicating artery

aneurysm presenting with

haemorrhage into an arachnoid

cyst