Nonimmune hydrops fetalis secondary to aneurysm of the vein of Galen.

Ann Saudi Med 28(1) January-February 2008 www.saudiannals.net 45 Aneurysm of the vein of Galen is a rare intracran nial vascular abnormality associated with sen vere hemodynamic and central nervous and/or system disturbance leading to intrauterine death and/or early neonatal death.1 It is associated with a wide range of abnormalities like cardiomegaly, ventriculomegaly, intrauterine growth restriction, hepatomegaly, enn larged neck vessels, polyhydramnios and vascular steal syndrome.2 Spontaneous intracranial hemorrhages are not uncommon in these aneurysmic malformations.3 Though nonimmune hydrops has been associated with wide variety of conditions ranging from structural heart disease, arrhythmias, chromosomal anomalies and inn trauterine infections, occurrence with aneurysm of the vein of Galen is rare. Diagnosis of this condition is usually made by ultrasound complimented with color Doppler and MRI.3n5 Though this condition was associn ated with more than 90% mortality in the past, a favorn able outcome has been reported recently with endovasn cular treatment and intensive neonatal care. However, morbidity cannot be entirely eliminated. We report a case of aneurysm of the vein of Galen that presented with cardiomegaly and hydrops that culminated in inn trauterine fetal demise.