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Teaching NeuroImage. Sankalp Gokhale, MD and Daniel T. Laskowitz, MD Department of Medicine (Neurology) Duke University School of Medicine Durham, NC, 27710 sankalpsgokhale@gmail.com. Clinical Details. 22 year old man presented with intractable progressive headaches over 2 months
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Teaching NeuroImage Sankalp Gokhale, MD and Daniel T. Laskowitz, MD Department of Medicine (Neurology) Duke University School of Medicine Durham, NC, 27710 sankalpsgokhale@gmail.com
Clinical Details • 22 year old man presented with intractable progressive headaches over 2 months • Neurological examination was normal • Based on CT scan and MRI scan, pineal mass was diagnosed. Intra-operatively, a firm mass with apparent venous drainage was observed • Digital subtraction arteriogram was normal • Histology confirmed diagnosis of vein of Galen (VG) related thrombosed aneurysm
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Figure Legend • Top Panel A. (Left) Non Contrast CT scan showing hyperdense mass in pineal region B. (Right) T1 weighted post contrast MRI image shows minimal contrast enhancement • Bottom Panel Digital subtraction angiogram demonstrating no arterial (C) (Left) or venous abnormalities (D)(Right) in the region of mass, implying thrombosed VG-aneurysm
References 1. Abe T, Matsumoto K, Kiyota K et al. Vein of Galen aneurysmal malformation in an adult: a case report. Surg Neurol; 1996:39-43. 2. Hoang S, Choudhri O, Edwards M, Guzman R et al. Vein of Galen malformation. Neurosurg Focus; 2009:27(5): 1-8