{
  "abstract": "A male neonate was delivered via spontaneous vaginal delivery with a birth weight of 2900 grams, appropriate for gestational age, to a G5P5A0 mother with hypothyroidism and gestational hypertension, managed with thyroxine and labetalol, respectively. No foetal abnormalities were detected during routine antenatal ultrasound scans, and no foetal Doppler or foetal MRI was performed during pregnancy. The neonate developed respiratory distress soon after birth. On examination, features included respiratory distress, widely open sutures and anterior fontanelle, visibly dilated neck veins with clinical signs of raised jugular venous pressure (JVP) ( online supplemental video 1), a continuous murmur, gallop rhythm, hepatomegaly and wide pulse pressures. A diagnosis of congestive cardiac failure was considered; however, 2D echocardiography ruled out any structural cardiac anomaly. A continuous cranial bruit over the anterior fontanelle prompted cranial ultrasound, which revealed a hypoechogenic ovoid midline structure posterior to the third ventricle (figure 1). A provisional diagnosis of Vein of Galen Aneurysmal Malformation (VOGM) or an arteriovenous fistula leading to high-output cardiac failure was considered. MRI confirmed the diagnosis of VOGM with arterial supply from the choroidal branches of bilateral posterior cerebral arteries and the pericallosal branches of bilateral anterior cerebral arteries. There was marked venous outflow congestion with gross dilatation of the internal jugular vein. The lateral ventricles were enlarged, with no evidence of trans-ependymal cerebrospinal fluid (CSF) leakage (figure 2).",
  "authors": [
    {
      "affiliations": [
        "Neonatology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"
      ],
      "name": "Choudri Muzafar Paswal"
    },
    {
      "affiliations": [
        "Neonatology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"
      ],
      "name": "Swasthi Kabi Satpathy"
    },
    {
      "affiliations": [
        "Radiodiagnosis, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India"
      ],
      "name": "Sarbesh Tiwari"
    },
    {
      "affiliations": [
        "Neonatology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"
      ],
      "name": "Sushil Kumar Choudhary"
    },
    {
      "affiliations": [
        "Neonatology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"
      ],
      "name": "Neeraj Gupta"
    }
  ],
  "title": "Vein of Galen malformation in a newborn: clinical presentation and imaging insights",
  "uid": "cb788dee-7298-50be-8d11-7619bc341c45"
}