Abstract A male infant weighing 2700 g was born by cesarean section at 35 weeks' gestation to a 31-year-old gravida 6 para 5 mother who had an uncomplicated pregnancy. At birth the infant was cyanotic and dysmorphic. An initial chest roentgenogram (Fig 1) and an echocardiogram were obtained. Echocardiography showed a dilated right atrium and biventricular enlargement with a large right-to-left ductal shunt. Despite intense medical therapy, the infant's level of oxygenation deteriorated. In anticipation of beginning extracorporeal membrane oxygenation therapy, cranial ultrasonography was performed (Fig 2). Following ultrasonography a skull series was obtained (Fig 3). Despite aggressive treatment the patient's condition worsened. Attempts at cardiopulmonary resuscitation provided only temporary improvement and he died within several hours. The Editors welcome contributions to Picture of the Month and Radiological Case of the Month. Those who wish to contribute should send their manuscripts to Dr Feingold (Picture of the Month), National Birth Defects References 1. Hoffman HJ, Chuang S, Hendrick EB, Humphreys RP. Aneurysms of the vein of Galen: experience at the hospital for sick children, Toronto . J Neurosurg . 1982;57:316-322.Crossref 2. Standbridge RDL, Westaby S, Smallhorn J, Taylor JFN. Intracranial arteriovenous malformation with aneurysm of the vein of Galen as cause of heart failure in infancy: echocardio-graphic diagnosis and results of treatment . Br Heart J . 1983;49:157-162.Crossref 3. Langer R, Kaufmann HJ. Arteriovenous malformation of the great cerebral vein (of Galen) in a newborn: diagnosis by ultrasound and digital subtraction angiography . Eur J Pediatr . 1987;146:87-89.Crossref 4. Schum TR, Meyer GA, Grausz JP, Glaspey JC. Neonatal intraventricular hemorrhage due to an intracranial arteriovenous malformation: a case report . Pediatrics . 1979;64:242-244. 5. Fontan JJP, Herrera M, Fina A, Peguero G. Periventricular calcifications in a newborn associated with aneurysm of the great vein of Galen . Pediatr Radiol . 1982;12:249-251.Crossref 6. Kogutt MS, Systemic air embolism secondary to respiratory therapy in the neonate: six cases including one survivor . AJR . 1978;131:425-429.Crossref 7. Brown ZA, Clark JM, Jung AL. Systemic gas embolus: a discussion of its pathogenesis in the neonate, with a review of the literature . AJDC . 1977;131:984-985.
American Journal of Diseases of Children – American Medical Association
Published: Jan 1, 1990