Cerebrovascular Anomalies: Pediatric Conditions We Treat

Cerebrovascular anomalies are conditions characterized by malformed blood vessels that can lead to hemorrhages, strokes, blood clots, and other complications. They often are treated by surgery. Neurosurgeons operate on congenital anomalies of the brain in order to restore normal blood flow to the brain and reduce these risks. Examples of pediatric cerebrovascular anomalies are:

• Aneurysm: Aneurysms can occur in any artery in the body. Intracranial aneurysms are treated by neurosurgeons.
• Arterial dissection: A tear in the wall of a blood vessel.
• Arteriorvenous fistulae: These are acquired, usually secondary to a trauma or clot in a major vein in the head. They are usually treated by an endovascular neurosurgeon.
• Arteriovenous malformation: An abnormal connection between arteries and veins, which is congenital (present at birth), and can be treated surgically, endovascularly, or with Gamma Knife^® radiosurgery, or a combination.
• Cavernous malformation: These can cause multiple small hemorrhages over time that can produce symptoms such as seizure, headache, or focal motor deficit, but rarely require surgery in the acute setting. Cavernous malformations may require surgery on an elective basis if the produce persistent symptoms that cannot be controlled by medication.
• Hemangioma: A rare benign tumor that usually appears during the first weeks of life and may disappear by age 10, but can sometimes be permanent. Hemangiomas are more common cutaneous anomalies.
• Moyamoya syndrome: This is the progressive narrowing of the carotid arteries and their branches, causing a decrease in the blood flow to the brain. This disease causes strokes, seizures, headaches, dystonia, and other neurologic symptoms until the surgical treatment is undertaken.
• PHACE Syndrome: Is a constellation of anomalies of the brain, heart, eyes, arteries of the head and neck, and large hemangiomas of the face or neck. Children with this syndrome may develop Moyamoya syndrome, and are at risk of seizures and stroke. Children may have all of these organ systems involved or only one.
• Vein of Galen malformation: A large amount of blood is shunted from arteries directly into the vein of Galen. This malformation can be diagnosed before birth by ultrasound, or after birth in a child who develops heart failure and/or hydrocephalus. These children are at risk of developmental delay and seizures.
• Venous sinus thrombosis: Is a blood clot that forms within a major vein in the head.

Visit the Pediatric Vascular Anomalies Center for more information on systemic vascular anomalies.

Research and Clinical Studies

Neurosurgery research at the Brain Care Institute is one of the top-funded programs in the country, with significant funding from the National Institutes of Health and various special-interest foundations . This high level of funding is a result of our extraordinary productivity, first-rate scientific investigations, and exceptional patient outcomes.

Here are some of the projects that are under way in the areas of vascular and cerebrovascular anomalies:

• In-depth research into the structural and functional maturation of the normal heart and blood vessels, as well as the causes for congenital heart disease and congenital cardiovascular malformations.