Definitive treatment of vein of Galen aneurysmal malformation with stereotactic radiosurgery

J Neurosurg. 2014 Jan;120(1):120-5. doi: 10.3171/2013.6.JNS121897. Epub 2013 Jul 19.


Vein of Galen aneurysmal malformations (VGAMs) are uncommon congenital malformations arising from fistulous communication with the median vein of the prosencephalon, a primitive precursor of midline cerebral venous structures. Angiographic embolization is the primary modality for treatment given historically poor microsurgical outcomes. Only a few reports of treatment by Gamma Knife radiosurgery (GKRS) exist in the literature, and the results are variable. The authors present 2 cases of VGAM in which GKRS provided definitive treatment with good outcome: one case involving antenatal presentation of a high-output, mural-type VGAM with complex clinical course refractory to multiple embolic procedures, and the other a choroidal-type VGAM presenting with hemorrhage in an adult and without a feasible embolic approach. With discussion of these cases and review of the literature, the authors advocate inclusion of GKRS as a therapeutic option for treatment of these complex lesions.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebral Veins / abnormalities*
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / surgery
  • Child, Preschool
  • Embolization, Therapeutic
  • Humans
  • Male
  • Radiography
  • Radiosurgery / instrumentation*
  • Treatment Outcome
  • Vein of Galen Malformations / diagnostic imaging
  • Vein of Galen Malformations / surgery*