Comprehensive Treatment for Cerebrovascular Disorders
Neurovascular Services at Nationwide Children’s Hospital provides comprehensive treatment for conditions that affect blood vessels in and around the brain and spine in patients of all ages, from infancy through adulthood. Using either open or endovascular approaches, we treat patients with rare and complex disorders to achieve the best possible outcomes.
A neurovascular (or cerebrovascular) disorder occurs when the brain experiences either excessive bleeding or restricted blood flow. These neurovascular disorders may include arteriovenous malformations (tangled blood vessels), moyamoya (narrowed blood vessels) or cavernous malformations (blood vessels that are enlarged or irregular). Children or adults of all ages may need neurovascular surgery to repair these conditions.
For some patients, the disorders may be identified early and referred for neurovascular surgery. In other cases, a patient’s condition may not be identified until they are admitted to the emergency department.
These disorders may be temporary or permanent, and can have many causes. These possible causes include stenosis (narrowing of a blood vessel), thrombosis (blood clots), embolism (blockage) or hemorrhage (ruptured blood vessel). Some people are born with these conditions, or they may be caused by an injury or another condition.
Nationwide Children's Hospital is ranked by U.S. News & World Report for Neurology and Neurosurgery.
About Our Services
Nationwide Children’s offers the full spectrum of care for neurosurgery patients, including a Level-I pediatric trauma center, oncology services and inpatient rehabilitation. Our services include all stages of patient care, from the initial consultation through surgery, post-operative care and rehabilitation. Our neurosurgeons and nurse practitioners have all received advanced pediatric training for treating the unique needs of children and adolescents, as well as young adults.
Neurosurgeons at Nationwide Children’s may perform neurovascular surgery with either an open approach or endovascular approach.
Conditions We Treat
The endovascular team at Nationwide Children’s offers consultations and treatment for common and complex conditions that affect blood vessels in the brain and spine. These include:
- Arterial dissection
- Arteriovenous fistula (AVFs)
- Cavernous malformations
- Cerebral cavernous malformation
- Cerebrovascular accident
- Intracranial aneurysm
- Intracranial hypertension
- Pseudoaneurysm thrombosis (craniovertebral disorder)
- Sinus pericranii
- Tumors of the head, neck and spine
- Vein of Galen malformation (rare type of AVM)
Our pediatric neurosurgeons can address these conditions with some of the most advanced surgical techniques. Our operating rooms are equipped with leading technology that allows surgeons to see deep into the brain and determine the best, most minimally invasive approach for each patient.
An endovascular approach usually involves the use of a catheter and medical imaging to guide the surgeon, rather than making incisions in the skull. Because it is minimally invasive, patients generally have shorter hospital stays and recovery times, as well as a reduced risk for complications.
Endovascular surgeries include:
- Coiling, which helps to block blood flow into an aneurysm, preventing it from breaking open and causing severe bleeding and brain damage
- Stenting, which involves reinforcing an aorta wall to prevent rupturing of a damaged area
- Angioplasty, which helps to restore blood flow if an artery is clogged, and is often combined with stenting
- Embolization, which cuts off blood supply to an aneurysm
An open approach to neurovascular surgery is a more traditional method. This may involve incisions in the skull and the use of a specialized microscope and surgical instruments to identify and repair the affected blood vessels.
With an open approach, the surgeon can directly repair the problem. For some aneurysms and vascular malformations, the open approach is often safer and more effective than the minimally invasive, endovascular approach.
At Nationwide Children’s, both types of surgery are provided in our neurosurgical operating room, the region’s newest state-of-the-art facility. Our neurovascular services include an intraoperative MRI, advanced neurosurgical microscope system and stereotactic guidance.
These tools help our neurosurgeons precisely target brain regions and create 3D models or real-time pictures of the inside of the brain and spinal cord. This allows us to ensure that each patient receives the best treatment for his or her condition.
Refer a Patient
Different neurovascular conditions have their own set of symptoms, such as headaches, neck pain, blurred vision, swelling, speech changes or dizziness. Some neurovascular conditions may present at birth, or in the emergency department as the result of injury. Medical imaging can help pinpoint issues in the vascular system and help neurovascular teams identify areas of concern and determine the best treatment method.
Neurosurgery at Nationwide Children’s offers rapid scheduling for clinic appointments and operations, with 24 hours for urgent cases and only a few days for non-emergent cases — one of the shortest appointment schedules among leading neurosurgery programs. We also provide an open line of communication with referring physicians dedicated to urgent patients.