Deep venous communication in vein of Galen malformations: incidence, Imaging, and Implications for treatment.

Background: Failure to appreciate deep venous drainage pathways is a major cause of severe complications in the endovascular treatment of vein of Galen aneurysmal malformations (VOGMs).

Objective: To report deep venous drainage patterns in patients with VOGM, emphasizing the internal cerebral veins, and to describe the challenges in evaluating these.

Methods: Patients with VOGM presenting to our institute between 2000 and 2018 were retrospectively analyzed.

Intracranial vessel wall MRI.

There are many different methods of imaging the intracranial arteries; however, the vast majority of currently used techniques are based on luminal imaging. Although this is useful, it does have limitations as many different pathological processes can produce the same appearance. Therefore, directly imaging the site of the pathology - the vessel wall itself - offers the hope of discriminating between different disease processes.