ARTERIOVENOUS FISTULA (ANEURYSM) OF THE GREAT CEREBRAL VEIN (OF GALEN) AND THE CIRCLE OF WILLIS

Abstract

ARTERIOVENOUS fistula (aneurysm) connecting the great cerebral vein (of Galen) and the circle of Willis is a congenital anomaly, apparently of rare occurrence and heretofore a pathologic curiosity. Only 6 examples of this defect have, to our knowledge, been described, 5 in the literature and 1 in a personal communication. In 5 cases the condition was noted at autopsy; in the sixth the diagnosis was made on the basis of observation at operation. The purpose of this paper is to present the cases of 2 living patients in whom this anomaly was discovered by means of cerebral angiography, to discuss the clinical course and treatment of the condition in these 2 children and to suggest that the anomaly may be commoner than one might suppose. REPORT OF CASES Case 1. —The child was referred by Dr. Ernst Wolf, of San Francisco, at the age of 16 months because of progressive