Vein of Galen Malformations

A vein of Galen malformation (VOGM) is a rare problem where there is an abnormal connection between arteries and one of the deep veins of the brain, called the vein of Galen. This causes blood to flow too quickly into the vein, potentially placing extra stress on the heart and affecting how blood circulates through the brain. VOGM develops before a baby is born. It is present at birth but may not be detected until later in infancy or childhood.

Mount Sinai Kravis Children’s Hospital is the highest-volume center in the United States for treating VOGM and pediatric vascular malformations, making it one of the most experienced programs in the world. The program provides coordinated care, from prenatal diagnosis through delivery, childhood, and long term follow-up, offering families coordinated expertise and compassionate guidance at every step. Led by Johanna T. Fifi, MD, a world-renowned expert in pediatric neurointervention, the team is at the forefront of advanced techniques, comprehensive management, and ongoing research and clinical innovation to improve therapies and outcomes. The VOGM program was founded by Alejandro Berenstein, MD. Dr. Berenstein pioneered the endovascular treatment of this condition and now leads the Vascular Malformations Research Center, continuing to drive discovery and progress in the field while supporting families throughout diagnosis, treatment, and lifelong care.

Signs and Symptoms

Signs and symptoms vary depending on age and severity. Many babies with VOGM are diagnosed during pregnancy or shortly after birth. In newborns, symptoms can include:

Rapid or difficult breathing
Enlarged head or bulging soft spot
Seizures
Poor feeding or difficulty gaining weight
Heart failure or heart strain
Low oxygen levels
Prominent scalp veins
Hydrocephalus (excess fluid in the brain)

Some children diagnosed later in infancy or childhood may present with:

Developmental delays
Headaches
Learning difficulties
Swelling of veins on the head or face
Enlarged head size
Seizures

Detection and Diagnosis

If VOGM is suspected, evaluation typically includes:

Prenatal ultrasound and fetal MRI for in-utero diagnosis
MRI/MR Angiography (MRA) to view brain vessels and blood flow
Ultrasounds
Echocardiography to assess the heart
Diagnostic angiography to fully evaluate the malformation, usually done in conjunction with the treatment

Early diagnosis is important because symptoms can progress quickly in critically affected newborns. For babies diagnosed before birth, our team works closely with maternal-fetal medicine and obstetrics to coordinate delivery at Mount Sinai, where immediate neonatal and neurointerventional care are available.

To schedule a consultation or speak with our team, please call 212-241-3400.

Our Multidisciplinary Approach

Vein of Galen Malformations are complex, and optimal care requires close collaboration among multiple specialists. At Mount Sinai, families are cared for by a dedicated pediatric multidisciplinary team that includes:

Pediatric Neurointervention for minimally invasive endovascular treatment and overall coordination of your child’s treatment
Maternal-Fetal Medicine and Neonatology for prenatal counseling and safe delivery planning
Pediatric Cardiology for monitoring and management of cardiac symptoms before and after delivery
Pediatric Neurosurgery
Pediatric Neurology
Intensive Care and Neurocritical Care Teams
Pediatric Nursing and Support Services
Social Work dedicated to the VOGM program and its patients

Our coordinated model ensures rapid intervention when needed, reduces transfer delays, and allows families to receive all aspects of care within one system. We regularly receive consultation from other hospital systems due to our world-renowned expertise and will coordinate with your doctors and health system to ensure the best possible outcome for your child.

Call 212-241-3400 to speak with our team or request a consultation.

Treatment Options

The primary treatment for VOGM is endovascular embolization, a minimally invasive technique in which tiny catheters are guided through the blood vessels up into the brain to block abnormal connections. Mount Sinai is internationally recognized for:

Advanced neonatal endovascular treatment
Safe, staged embolization strategies
Experience with the rarest and most severe cases
Access to innovative and emerging therapies
Long-term developmental monitoring and follow-up
Research that advances the field of VOGM management

Some newborns require treatment shortly after birth, while others benefit from staged procedures over time. Our team tailors an approach specific to each child’s anatomy, symptoms, and overall health.

Support for Families

Receiving a diagnosis of VOGM can be overwhelming. Our team is here to guide and support families through all stages of care. We offer:

Prenatal consultations and delivery planning
Coordination for transfer from outside hospitals
Social work and family support services
Clear communication at every step of treatment

Your family is not alone. Our specialists are committed to answering questions, helping families make informed decisions, and caring for your child with compassion.

Why Families Choose Mount Sinai

Largest VOGM treatment volume in the United States
Proven outcomes in high-acuity and complex cases
Leader in cutting-edge pediatric neurointervention techniques and management
Expert care across pregnancy, delivery, and childhood
Active research and clinical innovation program
Support for families throughout diagnosis, treatment, and long-term care

Our experience allows us to treat children with the highest level of safety and precision—giving families confidence that their child is receiving the best available care.

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