Question

MRI of skull represents:

• A. Vein of Galen
• B. Dandy Walker syndrome
• C. Pneumocephalus
• D. Crouzon syndrome

Hint:

Midline dilated venous channel in the quadrigeminal cistern behind the splenium.

Answer 1

The Correct Option is A

Step 1: The MRI shows a dilated venous channel in the quadrigeminal cistern behind the splenium of the corpus callosum, the typical location of an aneurysmal vein of Galen malformation (VGAM).
Step 2: The vein of Galen (great cerebral vein) is a short trunk formed by union of the two internal cerebral veins and the basal veins of Rosenthal. It lies in the quadrigeminal cistern and curves up around the splenium to drain into the confluence of the inferior sagittal and straight sinuses.
Step 3: An aneurysmal malformation of this vein results from arteriovenous shunting of blood and classically causes high-output congestive heart failure in neonates, or later developmental delay, hydrocephalus and seizures.
Step 4: Why not the others - Dandy Walker shows a cystic dilated fourth ventricle with vermian hypoplasia; pneumocephalus shows intracranial air; Crouzon is a craniosynostosis syndrome of the skull bones. The midline retro-splenial venous dilatation points to vein of Galen malformation.