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The University of Chicago Medicine - Comer Children's Hospital

Neurovascular Lesions

Cerebral Cavernous Malformation (CCM)

Four-year-old Zane Smith and his parents traveled from their home near Cambridge, England for a consultation with CCM expert Issam A. Awad, MD. Read his story.

The most common neurovascular lesions in children are cerebral cavernous malformations (CCM), also called:

  • Cavernous angioma
  • Cavernous hemangioma
  • Cavernoma

A CCM is a formation of fragile, dilated blood vessels that become tangled and form bubble-like structures called caverns. CCM lesions, often compared to the shape of a raspberry, may go undetected until they bleed and become symptomatic.

Our team of neurovascular care experts offers an unmatched level of definitive diagnosis and specialized care for CCM, including non-surgical and surgical management techniques.

Learn more about how our interdisciplinary physician team provides effective, comprehensive care for children and adults with CCM.

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.

Learn more about our multidisciplinary vascular anomalies group.

Moyamoya Disease

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.