Other malformations of cerebral vessels [Q28.3] / Other specified postprocedural states [Z98.89], Reason for Study: ^Reason: vein of Galen aneurysmal malformation, coiled, 6 month follow up History: 6 month follow up Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion.The prominent median prosencephalic vein is again seen and the maximum diameter of the vein is slightly increased (18.8mm, was measured about 17.5mm on T2 axial scan).However, there is no evidence of brain parenchymal edema or abnormal signal intensity indicating possible venous congestive encephalopathy.Otherwise signal intensity of brain as well as the myelination appears to be within normal limits and ventricle size is also within normal limits.Susceptibility lesions on bilateral lateral ventricle occipital horns are still seen which indicate possible prior hemorrhage related hemosiderin deposition, unchanged since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses are clear.Opacification of the right mastoid air cell is seen, slightly decreased in size comparing to prior scan which indicate immature status.Brain MRA 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate prominent and significant in-flow enhancement of median prosencephalic vein indicate still patent so called vein of Galen malformation. Vertebrobasilar arterial system appears to be enlarged in diameter indicate major feeding arterial system.Bilateral ICAs appear to be normal range diameter. There is no evidence of arterial aneurysm.
1. No evidence of acute ischemic or hemorrhagic lesion. In particular, there is no evidence of venous congestive encephalopathy. Ventricle size remains normal.2. Persistent filling of median prosencephalic vein which shows slightly increased in maximum diameter. However, there is no evidence of outlet occlusion or stenosis on this scan.3. Unchanged bilateral lateral ventricle occipital horn susceptibility lesions since prior scan. Otherwise brain parenchymal signal intensity and myelination appear to be within normal range.4. Brain MRA shows enlarged vertebrobasilar system luminal diameter indicate main feeding arterial system to the shunt toward median prosencephalic vein. 