Four-month-old infant with macrocephaly and prominent scalp veins

VOG malformation is a devastating diagnosis that commonly presents during the first months of life. Common presentations include macrocephaly, unexplained cardiac failure, enlarged facial veins, seizures, and/or the presence of a cranial bruit. It is imperative that a physician consider this diagnosis with any of these clinical presentations during the first year of life. If possible, cranial imaging, including evaluation of the VOG, should be obtained as soon as possible. Diagnosis of a VOG malformation is especially important in pediatric patients because, if left untreated, the risk of mortality is high and treatment modalities are now less invasive and increasingly successful.