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.
Patients are usually very sick and activity is inherently limited.
There is no specific medical therapy for the vein of Galen malformation. In infants where surgical ligation or selective embolization is performed the patient should be reimaged to assess results of the therapeutic intervention. Head circumference measurements should be obtained in patients where a ventriculoperitoneal shunt is performed to treat the hydrocephalus. Patients diagnosed with a vein of Galen malformation should be transferred to a tertiary neonatal intensive care unit where a pediatric neurologist, an interventional neuroradiologist, and a neurosurgeon are available for management of the infant. Over half the patients with a vein of Galen malformation have a malformation that cannot be corrected.