If you’re expecting a baby or have a newborn with a brain condition called a vein of Galen malformation (VOGM), you may have many questions. This rare condition can be serious, but advances in care have greatly improved outcomes.

What is a vein of Galen malformation?

A vein of Galen malformation is a rare condition that affects blood vessels in the brain. It develops before birth while the baby is still in the womb.

“In VOGM, some blood vessels connect the wrong way,” explains neurological surgeon William Thorell, MD. “Instead of blood flowing through tiny capillaries, it flows directly from arteries into veins. This causes very fast blood flow and puts stress on the brain and the heart.”

Although it’s called a “vein of Galen” malformation, the condition actually comes from a blood vessel that should disappear during early pregnancy but doesn’t.

Symptoms of vein of Galen malformations 

Symptoms vary depending on the severity of the malformation and the child’s age.

Newborns with severe VOGM may develop:

• Heart failure.
• Fast or troubled breathing.
• Poor feeding.

These symptoms occur because the heart must work much harder than normal to pump blood.

Babies with less severe VOGM may show symptoms later, including:

• Rapid head growth due to fluid buildup (hydrocephalus).
• Seizures.
• Developmental delays.

In rare cases, children are diagnosed later in childhood and may experience:

• Headaches.
• Seizures.
• Weakness or other neurological symptoms.

How is a vein of Galen malformation diagnosed?

Doctors may diagnose VOGM before birth during a prenatal ultrasound or fetal MRI. This allows families to plan delivery at a hospital with advanced neonatal and neurosurgical care.

After birth, imaging tests may include:

• MRI or MRA scans to examine the brain and blood vessels.
• CT scans to check for fluid buildup or bleeding.
• Cerebral angiography, a specialized test that shows detailed blood flow patterns.

Treatment options for vein of Galen malformations

“Treatment for vein of Galen malformations has improved significantly in recent years,” says Dr. Thorell. “Most children are treated using a minimally invasive procedure called endovascular embolization.”

During this procedure, the neurosurgeon guides a small tube through the blood vessels and place materials that reduce abnormal blood flow. Treatment is often performed in stages to protect the baby’s heart and brain.

Doctors may:

• Treat urgently if the baby has severe heart failure.
• Delay treatment for several months if the baby is stable.

The goal is to support healthy brain development while reducing stress on the heart.

Prognosis and long-term outcomes

Every child’s outcome is different. Prognosis depends on:

• The severity of the malformation.
• Whether brain injury occurred before or after birth.
• How successful treatment is.

Many children go on to live meaningful lives. Some may need ongoing support for learning or developmental challenges.

Why early diagnosis and specialized care matter

Vein of Galen malformations were once considered nearly always fatal. Today, early diagnosis and advanced treatment offer real hope.

Care is typically provided by a multidisciplinary team that may include neurologists, neurosurgeons, cardiologists and developmental specialists. This team-based approach can significantly improve outcomes and quality of life.