Related Experiment Video
Updated: Mar 22, 2026

Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye
Published on: September 5, 2011
Vein of Galen Aneurysmal Malformation in Monozygotic Twin
Masaki Komiyama1, Satoko Miyatake2, Aiko Terada1
1Department of Neurointervention, Osaka City General Hospital, Osaka, Japan.
Background:
Vein of Galen aneurysmal malformation (VGAM) is a rare pediatric vascular malformation of the brain. Genetic backgrounds are not well elucidated. We report on a monozygotic twin with VGAM and his endovascular treatment, and the genetic analyses of the twins and their parents.
Case Description:
In a monochorionic, diamniotic pregnancy of a 28-year-old healthy woman, monozygotic twins were born by emergency caesarian section because of fetal distress of the smaller twin at 25 weeks' and 4 days' gestation. Although a postnatal cranial ultrasound failed to detect VGAM in the smaller twin, mild heart failure persisted. A brain magnetic resonance (MR) examination of this twin on day 82 revealed choroidal VGAM. The twin was treated successfully by two sessions of embolization at 6 and 8 months of age. An MR examination at 1 year showed minimal residual arteriovenous shunts. He developed normally similar to the normal co-twin, with a follow-up period of 1 year and 6 months. As for the affected twin, no germline mutation or copy number variations were identified in ENG, ALK1, SMAD4, BMPR2, PTEN, RASA1, KRIT1, Marcavernin, or PDCD10 through whole-exome sequencing (WES).
Conclusion:
We have reported a rare combination of a monozygotic twin and VGAM and the successful endovascular treatment. Phenotypic discordance in monozygotic twins established early in embryogenesis could be attributable to environmental or epigenetic factors.
More Related Videos
09:04Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
Published on: September 5, 2011
09:51Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators
Published on: March 21, 2018
Related Concept Videos
Varicose Veins I: Introduction
Veins of Thorax
The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...
Esophageal Varices-I: Introduction
Overview of Systemic Veins
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
Anastomoses
Anastomoses can be formed at arterial, venous, and lymphatic vessels.
Arterial Anastomosis: These occur between arteries. They...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies