Vein of Galen Aneurysmal Malformations (VAGMs) are uncommon vascular malformations associated with dilatation of the vein of Galen embryonic forerunner with single or multiple direct arteriovenous fistulas within its wall without direct reflux into normal cerebral veins. We describe a patient with a late neurological onset presenting a classic VGAM complicated by secondary thalamic capillary angioectasia imaged with MR perfusion. In our patient, abnormal MR perfusion parameters were not seen on conventional MRI; they probably reflect underlying venous hypertension. They were located in areas involved in motor neurological deficit.
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