Vein of Galen aneurysms are a rare and complex vascular malformation of the brain. Their prevalence is somewhat less than 1 in 25,000 deliveries. Common associated anomalies include ventriculomegaly, cardiomegaly secondary to high cardiac output and enlarged neck vessels, the later being an almost pathognomonic sign. The prognosis for these neonates is poor with a mortality rate of 50% and a high risk for neurologic sequelae. Color flow Doppler studies of the fetal brain vasculature are a reliable method for diagnostic purposes. In this paper we present a case of a vein of Galen malformation diagnosed prenatally at 33 weeks of gestation using both 2D and color Doppler ultrasound modalities.
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