Endoscopic Third Ventriculostomy in an Untreated Vein of Galen Malformation Presenting Lately with Acute Obstructive Hydrocephalus: A Case Report

Abstract Mural-type vein of galen malformations (VoGMs) mostly manifest in later stages of infancy as macrocephaly, hydrocephalus, or failure to thrive unless previously diagnosed and treated. Hydrocephalus may have an insidious progressive presentation when caused by a hydrodynamic disorder because of increased venous pressure or it may more rarely have an acute presentation when caused by an obstruction of the cerebral aqueduct by direct compression of the VoGM. Literature is extremely limited on the success and safety of endoscopic third ventriculostomy (ETV) in acute obstructive hydrocephalus caused by an untreated VoGM. To the best of our knowledge, no report is present on children with untreated VoGM presenting with acute obstructive hydrocephalus that was treated with the combination of ETV and endovascular embolization and had an adequate follow-up period. Thus, we aimed to present a case for demonstrating the possible efficacy and safety of ETV under such conditions.