A vein of Galen malformation can sometimes be seen on a fetal ultrasound. It may be suspected in a newborn with respiratory distress or signs of heart failure and whose echocardiogram does not show any structural cardiac abnormality. It may also be suspected in an older baby or child who shows the symptoms of a vein of Galen malformation.
A definite diagnosis can be made with imaging tests:
A cranial ultrasound is a noninvasive imaging test that allows a neurosurgeon to see the location of an abnormality in the brain.
Computerized tomography (CT) and magnetic resonance imaging (MRI) scans, which are also noninvasive procedures, can produce detailed images of the brain. CT scans use X-rays and MRI scans use magnetic fields and radio-frequency waves to create images of the brain, but they cannot by themselves see the details of a vein of Galen’s structure, which are best seen on an angiogram.
A catheter angiogram (also known as cerebral angiography or cerebral arteriography) is a minimally invasive procedure that can provide a detailed image of blood flow in the brain. To perform an angiogram, a specialist called an interventional radiologist inserts a catheter into a blood vessel and feeds it gently toward the location of the suspected AVM. A special dye called a contrast agent is released through the catheter and makes its way to the malformation. The path of the contrast agent, when viewed on an x-ray, produces a detailed image of the malformation’s structure.
An angiogram may be performed along with a CT or MRI scan for greater detail. CT angiography combines the minimally invasive catheter angiogram with the noninvasive CT scan to provide detailed pictures of the malformation. A magnetic resonance angiogram (MRA) is an MRI combined with an angiogram, which allows the radiologist and neurosurgeon to examine the blood vessels as well as the structures of the brain. CT angiograms and magnetic resonance angiograms provide excellent diagnostic views of a vein of Galen malformation.
Treatment for a vein of Galen malformation depends on the severity of the condition. Some of the treatments may be:
New endovascular surgical procedures are available to treat the malformation itself, greatly improving the prognosis (see Surgery for Vein of Galen Malformation).
Reviewed by: Srikanth Boddu, MD, MSc
Last reviewed/updated: September 2023