Neurovascular Center of Excellence

If your child has a blood vessel disease of the brain or spine, we can help.

The Neurovascular Center of Excellence at UPMC Children's Hospital of Pittsburgh offers world-class care.

Our renowned experts work together to design the best treatment plan for your child, teen, or young adult. We treat youth up to age 23 who have conditions that affect the blood vessels in the brain and spine.

Contact the Neurovascular Center of Excellence at 412-692-5090.

Blood Vessel Conditions of the Brain and Spine We Treat

We treat neurovascular conditions in babies all the way to young adults.

Our caring team takes the time to explain the disorder, what to expect, and the treatment options.

Arteriovenous malformation (AVM) in the brain

If your child shows signs of bleeding from an AVM, take them to the nearest emergency department. Rapid treatment is crucial.

An AVM refers to tangled small blood vessels in the brain between arteries and veins. There are different types of AVMs, with the vein of Galen malformation being among the most severe.

AVMs often cause the blood to flow directly from an artery into a vein. This can reduce the blood flow further down the artery and cause the blood vessel to burst.

AVM symptoms can include:

  • Severe headaches.
  • Seizures.
  • Vomiting.
  • Paralysis.
  • Loss of consciousness. 

Diagnosing and treating your child's AVM

The first step of an AVM diagnosis is an angiogram.

Your child's doctor will inject dye into their blood vessels and take x-rays. The x-ray shows how the AVM affects the blood flow in the brain.

Doctors often suggest removing AVMs through surgery because long-term chances of bleeding problems are high, even if the short-term risk is low.

In some cases, they may use targeted radiation for an AVM that's:

  • Hard to reach.
  • Very small.
  • In a place that they can't access safely with open surgery.

Cerebral cavernous malformation (CCM)

A CCM is a mass of abnormal and thin-walled blood vessels in the brain.

Many CCMs won't cause any problems in your child. But some can bleed and cause symptoms. Bleeding is often minimal and not life-threatening.

Diagnosing and treating your child's CCM

Our expert team uses MRI to assess your child's CCM for bleeding and growth over time.

Sometimes, we'll take a wait-and-see approach to watch the condition over time and make sure it remains stable.

For CCMs that continue to bleed or grow, we'll suggest surgery to remove them. Doctors mostly do CCM surgery at least a few weeks after  hemorrhage.

We'll take time to explain all treatment options and why we suggest one approach over another.

Moyamoya

This is a rare condition by which one or more main arteries to the brain narrow. This reduces blood flow to the brain.

Moyamoya can cause:

  • Headaches.
  • Minor or severe strokes.
  • Seizures.
  • Movement disorders.

Diagnosing and treating your child's moyamoya

Because moyamoya gets worse over time, it's vital to catch and treat it early to decrease your child's risk of stroke. 

The Neurovascular Center at UPMC Children's Hospital is one of the few centers that can perform pial synangiosis or indirect bypass.

This intricate surgery reroutes healthy blood vessels from the scalp back to the brain. It allows new blood vessels to grow and supply blood flow to the brain.

If diagnosed early, many children with moyamoya can live long and healthy lives.

Brain aneurysms

This is a bulge in a blood vessel in the brain.

Diagnosing and treating brain aneurysms

Our team performs an angiogram to see how blood flows into and out of the aneurysm.

We use imaging to keep an eye on small aneurysms over time. Large or growing aneurysms need surgery because they can burst in the future.

Our expert surgeons send tiny instruments through the blood vessel to place a coil or mesh tube. This way, blood doesn't flow into the aneurysm.

We'll follow your child closely to assess healing and prevent future problems with blood flow in the brain.

Retinoblastoma

Retinoblastoma is cancer of the retina at the back of the eye.

Our surgeons direct medicine to the blood vessel behind the eye to treat it. This increases the success of the medication and reduces side effects.

Stroke

If your child shows signs of stroke, take them to the closest hospital right away. Rapid treatment is crucial.

We treat stroke with advanced surgical techniques, medicine, or both based on what will work best for your child.

We also work to learn the reason for the stroke.

And we'll follow up with you and your child to assess their healing and prevent future blood vessel problems.

Advanced Neurovascular Diagnostic and Treatment Options at UPMC Children's

Our surgical, imaging, and medical teams work together to ensure your child gets the most cutting-edge and evidence-based care.

Doctors across the country often refer children with complex neurovascular conditions to us.

Open neurovascular surgery

We use cutting-edge technology to perform surgery at a microscopic level. It helps us divert blood flow away from an area prone to bleeding or clotting.

One common surgery we do is pial synangiosis, a type of indirect bypass. A surgeon attaches a new blood vessel from the scalp to the brain's surface to let new blood flow to the brain. This maintains normal blood flow to the brain while eliminating abnormal blood flow.

Another common surgery is AVM removal. Surgeons use a microscope and small tools to remove the tangled blood vessels while preserving the normal vessels.

Children from across the U.S. come to us so they can get treatment for hard-to-reach and complex vessel problems.

Endovascular surgery

Before open surgery to remove a malformed part of the blood vessels, we first seal it with safe material. Some examples of this include medical-grade coils or glue.

This process — called embolization — reduces bleeding during surgery.

For this procedure, your child's surgeon:

  • Sends a small tube — or catheter — through a large blood vessel in the groin.
  • Uses x-rays to guide the small tube all the way to the malformed blood vessel.
  • Stops the blood flow to an aneurysm or AVM through the blood vessel without harming nearby tissue.
  • May place a stent (a tiny tube) beside an aneurysm in the blood vessel. Blood flows through the stent, cutting the aneurysm's blood supply. Over time, this causes the aneurysm to shrink.

We also use endovascular surgery to remove a blood clot in a stroke.

The surgeon guides a special tool through the tube that expands at the clot. They then pull the clot through the tube.

Gamma Knife® radiosurgery

Despite the name, this isn't a type of surgery. Instead, it involves sending high-powered radiation to a targeted area with surgical accuracy.

Doctors use this to treat very small or inoperable AVMs in the brain's blood vessels.

Blood thinners

Doctors prescribe blood thinners if surgery or other techniques aren't the best options for your child.

They also combine blood thinners with surgical and other treatments to prevent blood clots.

We'll choose the safest blood thinner for your child based on their:

  • Blood vessel condition.
  • Age.
  • Lifestyle.
  • Unique needs.

We use rapid tests to make sure your child has the correct dosing and adjust it as needed.

Why Choose UPMC Children's for Neurovascular Care?

  • Our team of experts, including geneticists and hematologists, provide your child with well-rounded, complete care.
  • We not only specialize in rare blood vessel conditions but are also experts in the unique anatomy and needs of children.
  • Our surgeons are experts in minimally invasive techniques. This means a lower risk of complications and a faster recovery time compared to standard approaches.
  • Doctors across the U.S. send their patients to us because of our expertise in diagnosing and treating these rare conditions.

Meet our children's neurovascular team

Your child's care team includes:

  • Neurosurgeons.
  • Neuroimaging doctors.
  • Stroke doctors.
  • Heart doctors.
  • Blood disease experts.

Our experts take the time to answer your questions and explain your child's treatment plan in detail. When you meet us, you'll feel sure knowing a whole team of world-leading experts is working for your child.