Anaesthetic management of vein of Galen malformation in a very low birth weight preterm baby for endovascular embolisation

Extra-cardiac arteriovenous malformations are rare causes of severe cardiac failure in the neonatal period. Aneurysmal malformation of the vein of Galen may lead to a diagnostic confusion because the presenting signs point to a cardiac cause of failure. Endovascular therapy is found to be an effective and safe therapeutic modality available to treat these lesions. Intervention in the newborn is difficult and is preferably postponed until about 5 months. We present the anaesthetic management of a very low birth weight preterm neonate with a vein of Galen malformation who needed intervention within the first week of life.