Question

This MRI of the skull represents:

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

Hint:

A dilated midline vein in the quadrigeminal cistern behind the splenium.

Answer 1

The Correct Option is A

Step 1: The MRI shows a dilated midline venous structure lying beneath the cerebral hemispheres in the quadrigeminal cistern, consistent with the vein of Galen (great cerebral vein), here seen as a vein of Galen malformation.

Step 2: The vein of Galen is a short trunk formed by the union of the two internal cerebral veins and the basal veins of Rosenthal. It curves around the splenium of the corpus callosum to drain into the straight sinus. A vein of Galen malformation appears as an enlarged midline venous pouch in this location.

Step 3: The distractors differ. Dandy-Walker syndrome shows a cystic dilatation of the fourth ventricle with cerebellar vermian hypoplasia. Pneumocephalus is intracranial air. Crouzon syndrome is a craniosynostosis with skull deformity. None matches the dilated midline vein, so vein of Galen (option a) is correct.