Case Report Chemical abscess post vein of Galen aneurysmal malformation embolisation with ethylene vinyl alcohol copolymer

Uday Bhanu Kovilapu, Rahul Dudhal, Saurabh Maheshwari, Peeyush Dhagat, Umesh K. Mishra

South African Journal of Radiology | Vol 28, No 1 | a2841 | DOI: https://doi.org/10.4102/sajr.v28i1.2841 | © 2024 Uday Bhanu Kovilapu, Rahul Dudhal, Saurabh Maheshwari, Peeyush Dhagat, Umesh K. Mishra | This work is licensed under CC Attribution 4.0
Submitted: 22 December 2023 | Published: 30 April 2024

About the author(s) Uday Bhanu Kovilapu, Department of Radiodiagnosis, Armed Forces Medical College, Pune, India
Rahul Dudhal, Department of Radiodiagnosis, Armed Forces Medical College, Pune, India
Saurabh Maheshwari, Department of Radiodiagnosis, Armed Forces Medical College, Pune, India
Peeyush Dhagat, Department of Radiodiagnosis, Armed Forces Medical College, Pune, India
Umesh K. Mishra, Department of Radiodiagnosis, Armed Forces Medical College, Pune, India

Abstract

Vein of Galen aneurysmal malformation (VGAM) is a rare congenital malformation characterised by arteriovenous fistulas between primitive choroidal arteries and the median prosencephalic vein, the embryonic precursor to the vein of Galen. Endovascular techniques have changed the management of these patients with improved prognosis. An eight-month-old with VGAM managed by endovascular embolisation using ethylene vinyl alcohol copolymer (EVOH) developed a chemical abscess - a rare complication. It was managed conservatively and showed promising clinical outcome.

Contribution: Chemical abscesses following EVOH embolisation are scarce – with imaging differentials, which include brain abscess and onyx granuloma. Knowledge and successful identification of this entity are essential as its management as prognoses differ. Chemical abscess is managed conservatively and has a good prognosis.

Keywords

vein of Galen; endovascular embolisation; ethylene vinyl alcohol copolymer (onyx); chemical abscess; onyx granuloma; brain abscess; VGAM; vein of Galen malformation.

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