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Great Cerebral Vein of Galen

vena cerebri magna Galeni

The great cerebral vein (vein of Galen) is a short, unpaired midline vein formed by the union of the two internal cerebral veins at the posterior end of the corpus callosum below the splenium. It courses posteriorly in the cisterna ambiens and joins the inferior sagittal sinus to form the straight sinus. It drains the deep white matter, basal ganglia, thalami, and lateral ventricle walls via the internal cerebral veins and the basal veins of Rosenthal.

Region: Head & Skull

Clinical Relevance

Clinical Notes

Vein of Galen arteriovenous malformations are congenital high-flow shunts between cerebral arteries and the primitive precursor of the vein of Galen (the median prosencephalic vein), presenting in neonates as high-output cardiac failure, hydrocephalus from aqueduct compression, and macrocephaly. They are managed by endovascular embolisation of feeding arteries, typically in staged sessions. The vein of Galen is also the site of the deep venous drainage compressed in pineal region tumours, which must be preserved during pinealectomy.

Pathology

Common Injuries & Conditions

Vein of Galen Malformation

A congenital arteriovenous malformation involving the median prosencephalic vein presents in neonates with high-output cardiac failure and cardiomegaly from massive cerebral arteriovenous shunting, managed by staged endovascular embolisation of arterial feeders to progressively reduce shunt flow.

Deep Venous Thrombosis at Vein of Galen

Thrombosis of the vein of Galen as part of deep cerebral venous sinus thrombosis produces bilateral thalamic infarction with profound alteration of consciousness, requiring urgent anticoagulation even in the presence of haemorrhagic transformation.