Neurovascular Disorders

A neurovascular disorder refers to any condition that affects the blood vessels in the central nervous system. A neurovascular disorder can also be referred to as a cerebral vascular disorder.

Neurovascular disorders are rare in the paediatric population.

  • Ateriovenous malformation (AVMs)

An abnormal tangle of thin walled blood vessels where the arterial and venous systems connect bypassing the capillary system. These are at rick of rupturing giving rise to a bleed in the brain. They are often classified by the Spetzler-Martin grading scale according to their size and location in the brain. 

  • Cerebral carvenomous malformations (Carvenomas)

Abnormal cluster of enlarged capillaries with low pressure flow due to a lack of significant feeding arteries or veins.

  • Cerebral Aneurysms

A ballooned weak area in the wall of artery supplying the brain.

  • Moya Moya disease

A rare chronic disease where there is narrowing or blocking of a portion of some of the significant arteries in the brain.

Until services are relocated to the new Childrens Hospital your child will be cared for by the CNC at CHI at Temple St in conjuction with the neurovascular team and specialised interventional radiologists in Beaumont Hospital.

If your child requires hospitalization they will be admitted to CHI at Temple but may be transferred to Beaumont Hospital or CHI at Crumlin for surgery or interventional radiology procedures depending on their age and condition.

A Neurovascular disorder can be diagnosed following the onset of symptoms cases by bleeding in the brain due to the underlying disorder (acute presentation) or by investigations carried out electively, often for other conditions (non acute presentation)

Acute Presentation

This occurs when a child is brought to their nearest emergency department with symptoms caused by a brain bleed which can vary from sudden collapse to headaches and vomiting or seizure activity

The child is then admitted to the Paediatric Unit and if required transferred to Intensive Care Unit or St Gabriels ward in CHI at Temple St for management of symptoms and if necessary, surgery to manage a brain bleed.

They will undergo diagnostic investigations to identify exact nature of neurovascular disorder that caused the brain bleed including a cerebral angiogram in Beaumont Hospital.

Following investigations the child’s case will be reviewed at a specialist meeting in Beaumont Hospital to map a treatment plan.

Following an acute presentation with a brain bleed the neurosurgery health and social care professional  team will be involved to help the child make the best possible recovery including if required referral to the neuro-rehabilitation service.

Non Acute Presentation

A Neurovascular disorder can be identified by medical investigations, sometimes for other conditions. and then the child will be referred to the neurosurgical team for outpatient review.

Following outpatient review an elective admission to St Gabriel’s ward for further investigations including cerebral angiogram in Beaumont hospital may be arranged.

After investigations are completed a multidisciplinary review of the child’s case with specialists in Beaumont Hospital takes place to map their treatment plan.

  • Surgical resection of the area of abnormal blood vessels
  • Surgical bypass surgery to improve blood supply to affect brain areas for Moya Moya disease
  • Embolisation of the neurovascular disorder (blocking of abnormal  blood vessels)
  • Referral for stereotactic radiosurgery in the UK (specialised targeted radiation)

All treatments are carried out concurrently with neuro-rehabilliation and medical care

Most children diagnosed and treated for a neurovascular disorder will remain under the care of the neurosurgical team until transitioned to the adult neurosurgical services at 16yrs.

Repeat investigation will be arranged for your child at regular intervals post initial treatment to monitor for any recurrance of the original disorder.