Pediatric Neurovascular Lesions
The most common neurovascular lesions in children are cavernous angiomas of the brain. These lesions are small tangles of blood vessels which do not have any intervening brain substance.
Although no one is sure why these tangles of blood vessels grow, they can produce devastating hemorrhages in certain circumstances. If possible, cavernous angiomas of the brain may be surgically removed--eliminating the risk of significant bleeding in the brain. When surgery is not possible because the vessels are in sensitive areas of the brain, Experts at the University of Chicago Medicine Comer Children's Hospital can treat them with focused radiation or radiosurgery. This approach is non-invasive and can reduce the risk of bleeding in the brain.
Arteriovenous Malformation (AVM)
Other pediatric vascular lesions include arteriovenous malformation (AVM) of the brain, which like those in adults, can lead to significant risk of bleeding and potential neurological devastation. The AVM is a tangle of abnormal blood vessels that is prone to bleed or irritate the brain. Symptoms of these lesions include seizures or small hemorrhages.
Once diagnosed, AVM of the brain can be treated by surgically removing the vessels feeding the malformations. Before surgery, a radiologist can also place small particles--or "glue"--in the blood vessels that supply the lesions to reduce bleeding during surgery. In addition, children with small AVM of the brain may undergo focused radiation treatment or radiosurgery--eventually destroying the abnormal blood vessels and significantly reducing the risk of bleeding.
Another, infrequent vascular problem in children is moyamoya disease. This syndrome was first seen in children of Japanese decent where the carotid arteries--two of the large feeding vessels to the brain--undergo an unexplained narrowing. Often, this causes stroke or other symptoms of insufficient blood flow to the brain, such as seizures or weakness. The brain responds by developing very small colleteral vessels that on radiographic images can appear to resemble a "puff of smoke," hence the Japanese name moyamoya, meaning puff of smoke.
Usually children with moyamoya respond well to a low risk surgery called pial synangiosis. In this procedure, neurosurgeons place an artery directly on the brain surface to give the brain additional blood flow. This artery is then sewn to the brain and over time will develop collateral blood supply to the areas that are in need of additional blood.