The vascular system of the brain of newborns, infants and growing children may be affected by rare disorders. Most of these conditions can be successfully treated. At Johns Hopkins, these vascular abnormalities are treated by a multidisciplinary group including pediatric neurosurgeons, interventional radiologists, neurologists and pediatricians.
The most common of these disorders include:
Depending on the problem, symptoms can be gradual or they can appear suddenly. Symptoms usually include:
- Acute onset of headaches
- Seizures as the first sign of trouble
- Head growth out of proportion to the body
Diagnosis of a Vascular Abnormality
If a child develops any of these vascular conditions, a thorough evaluation by a pediatric neurosurgeon is needed to diagnose the problem.
- Your doctor will conduct a thorough physical and will ask for a detailed family and patient history.
- Your doctor may order imaging of the brain through an MRI.
- Your doctor will also probably order an angiogram or arteriogram, to look at the blood vessels of the brain.
Treatment for a Vascular Abnormality
Sometimes, the interventional radiologists can treat the problem by injecting various materials in the blood vessels to help stop the source of bleeding. This treatment is called embolization, and can sometimes be a permanent cure. It also may stem the bleeding enough to make the surgery easier for the patient.
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For Aneurysms: Your pediatric neurosurgeon will determine the best course of surgical treatment, which may involve endovascular coiling (sealing the aneurysm from the rest of the circulatory system) or open craniotomy and clipping (sealing and clipping the aneurysm). The approach will be determined by the location of the aneurysm in the brain.
For AVM: The purpose of surgery is to correct the vascular abnormality. Other forms of treatment are available, like embolization, discussed above and Gamma Knife treatments. Those treatments used focused X-rays to burn away the abnormalities. However, there are drawbacks to those treatments that you should discuss in depth with your pediatric neurosurgeon.
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For Moyamoya: Your pediatric neurosurgeon will rebuild the blood supply of the carotid artery. This artery is the main supply for the brain.
Post Surgery Information
Follow-up care is extremely important in tracking the progress of a child’s recovery. Your pediatric neurosurgeon will schedule follow-up appointments to make sure your child is making a full recovery.