Often patients need to be intubated. Seizures should be managed with antiepileptic medications. Usually, neonate patients are given phenobarbital and phenytoin. Please see the Complex Partial Seizure and Neonatal Seizure chapters. Head circumference measurements should be obtained regularly and carefully followed, in order to detect hydrocephalus.
Death usually results from cardiac failure or cerebral decompression.
A few patients have been cured by surgical ligation of the arterial feeders from the posterior and middle cerebral arteries and plication of the aneurysm. Some malformations thrombose spontaneously. Neurosurgical evaluation should be obtained urgently to assess the extent and location of the vein of Galen malformation and to treat hydrocephalus. Cardiologist should evaluate the patient for congestive heart failure. Neonatologist should help coordinate care and decide if intubation and ventilatory support are required.