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Vein of Galen Malformations (VGM)

diagnosis and treatment of vein of galen malformations

VGM is a very rare condition affecting the blood vessels of the brain. Occurring during embryonic development, VGM’s are abnormal connections between arteries and the deep draining veins of the brain. Under normal conditions these arteries and veins are connected by capillaries that function to slow blood flow through the brain, allowing for the necessary exchange of oxygen and nutrients. VGM’s do not have capillaries, thus the blood flow can be extremely fast increasing the work of the heart. Causing excessive strain on the heart, the result can be cardiac failure, which is the most common symptom of this disease. The high flow of blood can also interfere with the normal blood drainage of the brain, which can cause the development of hydrocephalus.

Diagnosis

Sometimes this abnormality can be detected during a prenatal ultrasound, but not always. Infants with more severe cases have difficulty coping with the unusual blood flow and consequently develop heart failure. It is very important in diagnosing, not to confuse a VGM with an AVM. VGM’s have a thicker wall that is unlikely to rupture, where AVM’s are very thin walled and likely to rupture and bleed. Consequently, it is of grave importance that children suffering these conditions be evaluated and diagnosed by experts in this field so that appropriate measures are taken for treatment.

Treatment

Fortunately, this condition can now be treated with embolization, the injection of embolic agents that encourages blood clotting and closure of the VGM. This procedure involves the insertion of a micro catheter through the femoral artery that is threaded through the arterial network until the tip reaches the site of the malformation. The embolic agent is injected through a catheter. In cases of tiny infants this procedure may be done percutaneously. Sometimes several procedures are required to completely shut off all the circulation. Following successful embolization these children often make great strides in their development.