vein of galen aneurysmal malformation and high-output cardiac failure in a newborn

Background: vein of galen aneurysm (vga) is the most common form of symptomatic cerebrovascular malformation in neonates. it develops in a fetus in the first trimester of pregnancy due to unknown reasons, but it is likely to have a genetic etiology. the prognosis of vga is usually poor, particularly in newborns with heart failure due to high-flow intracerebral shunt. surgery and endovascular embolization are partially successful treatments for controlling congestive heart failure and pulmonary hypertension. case report: in this article, we present the case of a 3600-gram, full-term, female neonate hospitalized with respiratory distress and severe heart failure. the neonate was the second child of a 28-year-old mother. after echocardiography and brain sonography, she was diagnosed with the vein of galen malformation. the case had severe and persistent congestive heart failure and refractory pulmonary hypertension. conclusion: it is important to perform the auscultation of fontanel in newborns and consider vga as a differential diagnosis in the neonates with congestive heart failure.