Malformação Arteriovenosa da Veia de Galeno no Recém-Nascido

The Vein of Galen Aneurysmal Malformation (VGAM) represents about 1% of the intracranial vascular malformations. It is characterized by an increased dilatation of the Vein of Galen, containing multiple arteriovenous fistulas that drain to a median prosencephalic vein called vein of Markowski, precursor of the Vein of Galen. The etiology of VGAM is still unknown and has no relation with family medical history. During the perinatal period, the first clinical manifestation is generally the presentment of heart failure. Diagnosis can be done during pregnancy through the pregnancy ultrasound and, posteriorly, through transfontanellar ultrasound, magnetic resonance imaging and angiography, which is the gold standard exam. Nowadays, the safest and most accepted method of treatment is the endovascular embolization. We report a case of a newborn with a pregnancy ultrasound suggesting VGAM, with a classic presentation of heart failure 8 days after his birth, confirming the hypothesis with neuroimaging investigation. After clinical stabilization during hospitalization, the patient underwent embolization in 3 stages with good clinical outcome. The deterioration of the prognosis if not treated highlights the importance of an early diagnosis of this condition. Even though its rarity, it should be considered as differential diagnosis when facing a newborn with heart failure.