At the Neurovascular Center of Excellence, we treat health problems of the brain's blood vessels in babies to young adults.
Our caring team at UPMC Children's Hospital of Pittsburgh takes the time to explain your child's health issues. We'll also lay out treatment options, next steps, and what to expect during treatment.
Arteriovenous Malformation (AVM)
An AVM is a tangle of small blood vessels in the brain. AVMs 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.
If your child shows signs of an AVM having burst, take them to the nearest emergency room. Rapid treatment is crucial.
Symptoms of a burst AVM
AVM rupture symptoms can include:
- A severe headache.
- Seizure.
- Vomiting.
- Paralysis.
- Loss of consciousness.
There are different types of AVMs, with the vein of Galen malformation being among the most severe.
Diagnosing and treating your child's AVM
The first step of an AVM diagnosis is an angiogram. The doctor will inject dye into the blood vessels and take x-rays. The x-ray shows how blood flows through the brain.
Sometimes doctors inject glue during an angiogram. This helps decrease the risk of bleeding during further treatment.
Even when an AVM hasn't burst, it poses a risk of bleeding. The short-term bleeding risk is low, but the long-term risk is high.
Doctors suggest either surgery or radiation to treat an AVM.
With surgery, they remove your child's AVM.
In some cases, doctors 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. But some can rupture and cause symptoms.
Even in those that burst, the bleeding is often minimal and not life-threatening.
Diagnosing and treating your child's CCM
Our expert team uses MRI to check your child's CCM for bleeding and growth over time. Sometimes, we'll wait and see to watch the issue 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 the brain starts bleeding.
We'll take time to explain all treatment options and why we suggest one over another.
Moyamoya
Moyamoya is a rare health issue 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 issues.
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 does pial synangiosis surgery, sometimes called indirect bypass.
This 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
A brain aneurysm is a bulge in a blood vessel in the brain.
This bulge can burst and cause bleeding 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 a 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 medicine and reduces side effects.
Stroke
Learn about the Pediatric Stroke Program at UPMC Children's.
If your child shows signs of stroke, take them to the closest hospital right away. Swift treatment is crucial.
We treat stroke with advanced surgery, 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.
