Mehrdad Mirzarahimi - neonatologist, Pediatric Department, Bouali Children’s Hospital, Ardabil University of Medical Sciences (ARUMS),ardabil,iran
Farzad Ahmadabadi - pediatric neurologist, Pediatric Department, Bouali Children’s Hospital, Ardabil University of Medical Sciences (ARUMS),ardabil,iran
Faramarz Ajri - pediatric cardiologist, Pediatric Department, Bouali Children’s Hospital, Ardabil University of Medical Sciences (ARUMS),ardabil,iran
Reza Maskani - pediatriction, Pediatric Department, Bouali Children’s Hospital, Ardabil University of Medical Sciences (ARUMS),ardabil,iran
Sonia Hosseini Anbaran - medical doctor,Ardabil university of medical science,ardabil,iran

The vein of Galen aneurysmal malformation is a choroidal type of arteriovenous malformation involving the vein of Galen forerunner and distinct from an arteriovenous malformation with venous drainage into a dilated, but already formed vein, vein of Galen.A term male baby was born by Caesarean section. The pregnancy was uneventful and the mother didn’t have any significant medical history. At 24 h of age, he presented with features suggestive of cardiac failure ( poor feeding, cyanosis, tachypnea. A grade 4/6 systolic murmur heard all over the praecordium). Blood pressure and pulses were normal. Bounding carotid pulses were palpable. A thorough clinical examination cranial bruit was listen. the lab test was normal. In echocardiography, he had dilatation of SVC with high-velocity continuous flow, dilatation of Aortic arch and carotid arteries, and had severe TR,PDA, dilated all cardiac chambers and holodiastolic retrograde diastolic flow in the thoracic aorta.A bedside cranial ultrasound examination showed dilatation of lateral ventricular and midline and cystic mas posterior to the third ventricle, suggestive of Vein Galen Aneurysm malformation.Brain CT Confirmed the diagnosis.Brain CT scan: A large aneurysmal vascular structure is in pineal region draining into falcian sinus. Posterior part of superior sagittal sinus, transverse and sigmoid sinuses are enlarged with multiple tortuous feeding arteries from posterior and anterior circulation The vein of Galen aneurysmal malformation is a rare condition. The main clinical presentation there was congestive cardiac failure, although rare, it is important to highlight the fact that all cases of cardiac failure may not be due to primary cardiac cause.Our patient presented with high-output cardiac ( that EF in echocardiography was 50%) and poor sucking. we start digoxin for patient and transfer him to unit intervention radiologist but,Unfortunately our patient died after two days due to cardiac arrest from sever heart failure.

vein of Galen, malformation, brain