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Diagnosis and Management of a Thrombosed Vein of Galen Aneurysm: A Case Study

A 22-year-old man presented with intractable progressive headaches over two months. Neurological examination revealed no abnormalities, leading to a CT and MRI scan that diagnosed a pineal mass. Intra-operative findings showed a firm mass with venous drainage. A digital subtraction arteriogram indicated no vascular abnormalities. Histological analysis confirmed a diagnosis of a thrombosed vein of Galen aneurysm. This case emphasizes the importance of imaging and histopathology in diagnosing vascular malformations in the brain.

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Diagnosis and Management of a Thrombosed Vein of Galen Aneurysm: A Case Study

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  1. Teaching NeuroImage Sankalp Gokhale, MD and Daniel T. Laskowitz, MD Department of Medicine (Neurology) Duke University School of Medicine Durham, NC, 27710 sankalpsgokhale@gmail.com

  2. Clinical Details • 22 year old man presented with intractable progressive headaches over 2 months • Neurological examination was normal • Based on CT scan and MRI scan, pineal mass was diagnosed. Intra-operatively, a firm mass with apparent venous drainage was observed • Digital subtraction arteriogram was normal • Histology confirmed diagnosis of vein of Galen (VG) related thrombosed aneurysm

  3. A BAB C C D

  4. Figure Legend • Top Panel A. (Left) Non Contrast CT scan showing hyperdense mass in pineal region B. (Right) T1 weighted post contrast MRI image shows minimal contrast enhancement • Bottom Panel Digital subtraction angiogram demonstrating no arterial (C) (Left) or venous abnormalities (D)(Right) in the region of mass, implying thrombosed VG-aneurysm

  5. References 1. Abe T, Matsumoto K, Kiyota K et al. Vein of Galen aneurysmal malformation in an adult: a case report. Surg Neurol; 1996:39-43. 2. Hoang S, Choudhri O, Edwards M, Guzman R et al. Vein of Galen malformation. Neurosurg Focus; 2009:27(5): 1-8

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