Hydrocephalus associated with arterio-venous malformation - the vein of Galen aneurysm

Aneurysm of the vein of Galen is a rare cause of hydrocephalus. It should be suspected clinically when there are dilated frontal veins, and/or an intra-cranial bruit. Nearly all cases present in infancy. CAT brain scans will demonstrate the vascular lesion and the degree of hydrocephalus. Arteriography is only thought to be necessary if ablative surgery is planned; embolisation treatment may be applicable. Four cases from the Sheffield Children's Hospital are reported in detail and the methods of diagnosis and possible treatment are discussed.