Vein of Galen Malformation (VOGM)

What is a vein of Galen malformation?

A vein of Galen malformation (VOGM) is a type of rare blood vessel abnormality inside the brain. In VOGM, misshapen arteries in the brain connect directly with veins, instead of connecting with capillaries, which help slow blood flow. This causes a rush of high-pressure blood into the veins.

This extra pressure in the veins can cause a number of problems:

  • The rush of blood toward the heart and lungs forces the heart to work overtime to get blood to the rest of the body. This can lead to congestive heart failure in some infants.
  • Blood pressure in the arteries from the heart to the lungs may rise, causing a serious condition called pulmonary hypertension.
  • The high pressure in the veins can prevent the infant’s brain from draining adequately. This can lead to widespread brain injury and sometimes causes severe loss of tissue in the brain.
  • Some infants can develop hydrocephalus an enlarged head) if the VOGM blocks the normal flow of fluid in the brain.

If not diagnosed and treated early, VOGM can cause severe problems and may even be life threatening.

 

What are the symptoms of vein of Galen malformation?

Symptoms of a vein of Galen malformation (VOGM) usually begin shortly after birth or during early childhood.

Common symptoms may include:

  • heart failure, often within the first day or two of life
  • hydrocephalus
  • unusually prominent veins on the face and scalp
  • developmental delays
  • persistent headache
  • in very rare cases, a bleed in the brain

What are the causes of vein of Galen malformation?

A VOGM occurs during a baby’s early prenatal development, usually during the first trimester. It is not known exactly what causes a VOGM, but it is likely genetic.

VOGM sometimes, but not always, occurs with vascular anomalies that affect other parts of the body. They generally are not inherited.

How we care for vein of Galen malformation

The Boston Children’s Hospital Cerebrovascular Surgery and Interventions Center is one of the few pediatric centers in the world that specializes in treating VOGMs.

We bring together an unusually large number of specialties to care for your child, matched by few other hospitals. They include pediatric specialists in vascular anomalies, neonatal intensive care, cardiology, neurology, neuroanesthesiology, neurointerventional radiology, and neurosurgery, as well as staff in our Medical-Surgical Intensive Care Unit, whose expertise is critical in ensuring the best outcomes.

Our physicians attend weekly conferences with the Vascular Anomalies Center at Boston Children’s. Through active research, we are constantly exploring methods to make a more precise diagnosis of VOGM and seeking new treatments.

Fetal intervention for vein of Galen malformations

Boston Children’s Cerebrovascular Surgery and Interventions Center is conducting a clinical trial on fetal intervention for vein of Galen malformation, along with specialists from Boston Children’s Maternal Fetal Care Center and the Brigham and Women’s Hospital Maternal Fetal Medicine Group. Visit our study page to learn more.