Spontaneous thrombosis of vein of Galen malformation

Vein of Galen malformation (VGM) is an uncommon vascular anomaly, with spontaneous thrombosis within it being exceedingly rare. This case report describes a paediatric patient in early adolescence who presented with a 15-day history of holocranial headache and vomiting. Examination revealed significant papilloedema, and imaging confirmed a thrombosed VGM causing upstream hydrocephalus. To address the obstructive hydrocephalus, the patient underwent an endoscopic third ventriculostomy (ETV), which successfully alleviated symptoms and provided an uneventful recovery without the need for a ventriculoperitoneal shunt. This case highlights the potential for ETV as an effective treatment for obstructive symptoms arising from thrombosed VGMs, offering an alternative to traditional shunt procedures. Spontaneous thrombosis in VGMs, although rare, can lead to significant complications, and prompt intervention is crucial to achieve favourable outcomes.