ArticleRadiology case reports2026
Adult subarachnoid hemorrhage from vein of Galen aneurysmal malformation due to ruptured feeder aneurysm: A case report with long-term MRI review.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Adult hemorrhage from a previously treated vein of Galen aneurysmal malformation (VGAM) is exceedingly rare, and rupture of a flow-related feeder aneurysm has only been documented once in the adult case. We report a 20-year-old man with subarachnoid hemorrhage who presented with sudden headache. He had undergone palliative transarterial embolization (TAE) for choroidal-type VGAM during infancy for several times and had been followed annually with MRI at another institution. Digital subtraction angiography demonstrated two small feeder aneurysms, one presumed to have ruptured; additional embolization achieved complete occlusion of both aneurysms and a marked reduction in shunt flow. Retrospective review of serial MRIs showed progressive stenosis and eventual occlusion of the left transverse sinus, with first visualization of a feeder aneurysm one year prior to the rupture. This case represents only the second adult VGAM hemorrhage clearly attributed to a feeder artery aneurysm. Progressive venous sinus changes on follow-up MRI should prompt early angiographic re-evaluation and consideration of prophylactic treatment based on individual hemodynamic risk.
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