Vein of Galen malformation (VOGM) is a rare congenital cerebrovascular anomaly in which abnormal connections form between cerebral arteries and the median prosencephalic vein (precursor of the vein of Galen). This results in high-flow arteriovenous shunts that can cause heart failure, hydrocephalus, and neurological complications in neonates and infants. Symptoms include rapid heart rate, respiratory distress, seizures, developmental delay, and enlarged head size. Early detection and management are critical to prevent irreversible brain damage and cardiac complications. Specialized pediatric neurosurgical care is required to carefully plan treatment and minimize risks while preserving neurological function and overall growth.
Diagnosis typically involves prenatal ultrasound, MRI, and CT angiography to visualize the vascular malformation, its size, and associated brain abnormalities. Cerebral angiography is often used postnatally to map the precise arterial feeders and venous drainage, guiding treatment planning. Early and accurate diagnosis allows timely intervention, preventing heart failure, hydrocephalus, or long-term neurological deficits. Multidisciplinary evaluation by neurosurgery, cardiology, and interventional radiology ensures comprehensive assessment.
Treatment primarily involves endovascular embolization, a minimally invasive procedure to close abnormal blood vessels and reduce blood flow through the malformation. In rare cases, microsurgical intervention may be required. The timing and technique depend on the patient’s age, clinical condition, and vascular anatomy. The goal is to reduce hemodynamic stress, relieve hydrocephalus, and protect brain development while minimizing procedural risks.
Post-treatment, infants are closely monitored for neurological function, heart health, and fluid balance. Imaging studies confirm successful embolization and detect residual malformations. Rehabilitation may include physiotherapy, occupational therapy, and developmental support to address motor, cognitive, or sensory delays. With timely intervention, most patients achieve improved neurological outcomes, reduced cardiac strain, and better long-term growth and development.
Dr. Vamsi Krishna, Consultant Neurosurgeon at Yashoda Hospitals, Hitech City, Hyderabad, specializes in complex pediatric cerebrovascular disorders. His expertise in endovascular and microsurgical techniques ensures precise, safe treatment of Vein of Galen malformations, optimal neurological protection, and long-term developmental outcomes, making him a trusted specialist in this rare condition.
