A 7-year-old boy presented with headache, seizures, and vomiting to A&E. MRI was requested to rule out intracranial pathology. The study revealed appearances of Vein of Galen aneurysmal malformation (VGAM), a rare congenital arteriovenous malformation.

It is one of the differentials for midline cystic lesions detected on perinatal head ultrasonography. VGAM takes up signal on color Doppler interrogation and shows pulsatile flow within it. It is seen posterior to the third ventricle in the cistern of the velum interpositum.