Neurovascular Disease and Stroke Program

Vascular problems in children's developing brains require special individualized care in an experienced pediatric center. 

In Pediatric Cerebrovascular Neurosurgery, we have a multispecialty team working together to offer the best diagnostic and treatment options for our patients. There are few programs of this kind. Pediatric stroke and pediatric neurovascular diseases are relatively rare: finding specialists who all work together to treat children with these conditions is even more rare.

We know it is not enough for one neurosurgeon or one neurologist to provide an opinion: there are so many questions to address for the health and well-being of the patient and for the family. Thus we have put together a team-based approach for infants, children, and young adults with neurovascular and cerebrovascular conditions: in other words, disorders of blood vessels in the brain.

Patients and their parents spend time with our vascular genetics team including our neurogenetics pediatric neurologist and our genetics counsellor to understand the implications of diagnosis not only on the child, and also on siblings and future family planning. ​

We have a multidisciplinary pediatric neurovascular conference, where we discuss pediatric neurovascular cases and obtain consensus for best treatment recommendations for each child.

Pediatric specialists involved in the spectrum of care include neurosurgeons, endovascular neurointerventional neurosurgeons, neurologists, neuroradiologists, critical care intensivists, anesthesiologists, physical medicine and rehabilitation physicians, as well as dermatologists, hematologists, interventional radiologists, and geneticists. 

In certain conditions such as moyamoya associated with sickle cell disease or neurofibromatosis, the hematology and oncology team will be very involved in managing care as well.


The Lurie Children’s Difference

We work closely with the Vascular Anomalies Clinic/Vascular Lesion Center when appropriate, where vascular problems involve areas outside of the brain. While some neurovascular diseases are isolated to the brain, some vascular diseases involve other organ systems in the body and the whole clinical picture needs to be assessed and treated holistically. Multidisciplinary care for children is essential, especially in rare and difficult cases.

In certain conditions such as moyamoya associated with sickle cell disease or neurofibromatosis, experts in the pediatric hematology and oncology team will be very involved in managing care as well.

In addition, we offer participation in our tissue biobank, where surgical samples after AVM resection, cavernous angioma removal, and moyamoya surgery are stored securely for future study, to help patients and future patients as science evolves.

Our team has multidisciplinary and multimodal experience in AVM surgery, cavernous angioma management, moyamoya surgery, and vein of Galen malformation management over many years.

Conditions We Treat

Conditions we specialize in include:

Our Specialists

Neurosurgery

Sandi K. Lam, MD, MBA

Division Head, Neurosurgery

Professor of Neurological Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Tord D. Alden, MD

Attending Physician, Neurosurgery; Chief Medical Informatics Officer; Member, Lurie Children's Surgical Foundation

Associate Professor of Pediatric Neurosurgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Arthur J. DiPatri, Jr., MD

Attending Physician, Neurosurgery; Member, Lurie Children's Surgical Foundation

Associate Professor of Neurological Surgery, Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Endovascular

Ali Shaibani, MD

Attending Physician, Medical Imaging (Radiology)

Chief of Neurointerventional Radiology in the Department of Radiology and Professor of Radiology and Neurological Surgery, Northwestern University Feinberg School of Medicine

Call 312.227.4277

Donald R. Cantrell, MD

Attending Physician, Medical Imaging (Neuroradiology)

Assistant Professor of Radiology (Neurointerventional Radiology), Northwestern University Feinberg School of Medicine

Call 312.227.4277

Neurology

Jonathan Kurz, MD, PhD

Attending Physician, Neurology

Assistant Professor of Pediatrics (Neurology), Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Divakar S. Mithal, MD, PhD

Attending Physician, Neurology

Instructor of Pediatrics (Neurology and Epilepsy), Northwestern University Feinberg School of Medicine

Call 1.800.543.7362

Genetics Counselors

Erin McGinnis, MS, CGC

Emily Bryant, MS, CGC

What to Expect

You will meet our treatment team to review diagnoses, next steps, and treatment options if appropriate, as well as expected follow up plans. You and your family will have the opportunity to meet with our genetics counsellors to review any questions you might have about other children and extended family.

Our Lurie Children's Pediatric Neurosurgery and Neuroendovascular team, along with Neurology and Vascular Anomalies experts work together to provide patient-centered and family-centered care.

Make an Appointment

Please call 312.227.4220 to request an appointment.  

While many multidisciplinary team appointments are conducted in person, telemedicine options are available.

For more information that is not time-sensitive, please also email neurosurgerydivision@luriechildrens.org or neurogenetics@luriechildrens.org.

Research

See our team's recent neurovascular publications. We are committed to excellent coordinated care for all children with neurovascular conditions.

While we are continually providing top-notch clinical care, and we are also developing better techniques and treatments for our patients and for advancement of the field for all children in the future.

We are also studying the underlying genetic mechanisms of neurovascular disease in children, partnering with genetics specialists and basic science labs to find molecular targets to modify the disease course for patients with these diagnoses.

Publications

Below see a selection of our group's published work in pediatric neurovascular diseases:

LoPresti MA, Goethe EA, Bayley JC, Bertot B, Kan PT, Lam S. Endoscopic ultrasonic aspiration of an intraparenchymal hematoma in a newborn. J Neurosurg Peds. Oct 2, 2020. Epub ahead of print.

Cherian J, Srinivasan V, Froehler MT, Grossberg JA, Cawley CM, Hanel RA, Puri A, Dumont T, Ducruet AF, Albuquerque F, Arthur A, Cheema A, Spiotta A, Anadani M, Lopes D, Saied A, Kim L, Kelly CM, Chen PR, Mocco J, De Leacy R, Powers CJ, Grandhi R, Fargen KM, Chen SR, Johnson JN, Lam S, Kan P. Flow Diversion for Treatment of Intracranial Aneurysms in Pediatric Patients: Multicenter Case Series.
Neurosurgery. 2020 Jul 1;87(1):53-62.

LoPresti MA, Goethe EA, Lam S. Surgical strategies for management of pediatric arteriovenous malformation rupture: the role for decompressive craniectomy. Child's Nervous System. 2020 Jul;36(7):1445-1452.

LoPresti MA, Giridharan N, Kan P, Lam S. Natural history of high-grade pediatric arteriovenous malformations: implications for management options. Child's Nervous System. 2020 Mar 12. Epub ahead of print.

LoPresti MA, Giridharan N, Pyarali N, Gadgil N, Kan PT, Niedzwiecki C, Lam S. Pediatric intracranial arteriovenous malformations: examining rehabilitation outcomes. J Pediatr Rehabil Med. 2020;13(1):7-15.

Ravindra VM, Kralik SF, Griauzde J, Gadgil N, LoPresti MA, Lam S. Preoperative computed tomography perfusion in pediatric moyamoya disease: a single-institution experience. J Neurosurg Pediatr. 2020 Jan 24:1-8. Epub ahead of print

Aristova M, Vali A, Ansari SA, Shaibani A, Alden TD, Hurley MC, Jahromi BS, Potts MB, Markl M, Schnell S. Standardized Evaluation of Cerebral Arteriovenous Malformations Using Flow Distribution Network Graphs and Dual-venc 4D Flow MRI. J Magn Reson Imaging. 2019 Dec;50(6):1718-1730.

LoPresti MA, Ghali MZ, Srinivasan VM, Morris SA, Kralik SF, Chiou K, Du RY, Lam S. Neurovascular findings in children and young adults with Loeys Dietz syndrome: recommendations for screening. J Neurol Sci. 2020 Feb 15;409:116633.

LoPresti M, Treiber JM, Srinivasan VM, Chintalapani G, Chen SR, Burkhardt JK, Johnson JN, Lam S, Kan P. Utility of Immediate Postprocedural Cone Beam Computed Tomography in the Detection of Ischemic and Hemorrhagic Complications in Pediatric Neurointerventional Surgery. World Neurosurg. 2020 Mar;135:e405-e409.

LoPresti MA, Ravindra VM, Pyarali M, Goethe EA, Gadgil N, Wagner KM, Kan PT, Lam S. Pediatric Intracranial Arteriovenous Malformations: A Single Center Experience. Journal of Neurosurgery: Pediatrics. 25:151-158, 2020.

Cherian J, Srinivasan V, Froehler MT, Grossberg JA, Cawley CM, Hanel RA, Puri A, Dumont T, Ducruet AF, Albuquerque F, Arthur A, Cheema A, Spiotta A, Anadani M, Lopes D, Saied A, Kim L, Kelly CM, Chen PR, Mocco J, De Leacy R, Powers CJ, Grandhi R, Fargen KM, Chen SR, Johnson JN, Lam S, Kan P. Flow Diversion for Treatment of Intracranial Aneurysms in Pediatric Patients: Multicenter Case Series. Neurosurgery. 2020 Jul 1;87(1):53-62.

Goethe E, LoPresti MA, Kan P, Lam S. The role of spinal angiography in the evaluation and treatment of pediatric spinal vascular pathology: a case series and systematic review. Childs Nerv Syst. 2020 Feb;36(2):325-332.

Maynard K, LoPresti MA, Iacobas I, Kan P, Lam S. Anti-angiogenic agent as a novel treatment for pediatric intracranial arteriovenous malformations. Journal of Neurosurgery: Pediatrics. Oct 4 2019. Epub ahead of print.

Muir M, Patel R, Gadgil N, Pan IW, Lam S. Postoperative 30-day outcomes after craniotomy for supratentorial AVM resection in children. J Clinical Neurosci. 2019 Dec;70:108-112.

LoPresti M, Srinivasan VM, North R, Ravindra VM, Johnson JN, Burkhardt JK, Lam S, Kan P. Endovascular stenting for rescue of a failed donor graft during superficial temporal artery to middle cerebral artery bypass surgery: case report. Journal of Neurosurgery: Pediatrics. Aug 2019. Epub ahead of print.

Harris DA, Sorte DE, Lam S, Carlson AP. Blunt cerebrovascular injury in pediatric trauma: a national database study. J Neurosurg Pediatr. Jul 2019. Epub ahead of print.

Al-Smadi AS, Ansari SA, Shokuhfar T, Malani A, Sattar S, Hurley MC, Potts MB, Jahromi BS, Alden TD, Dipatri AJ Jr, Shaibani A. Safety and outcome of combined endovascular and surgical management of low grade cerebral arteriovenous malformations in children compared to surgery alone. Eur J Radiol. 2019 Jul;116:8-13.


Wagner KM, Ghali MGZ, Srinivasan VM, Lam S, Johnson J, Chen S, Kan P. Vein of Galen malformations: the Texas Children's Hospital Experience in the modern endovascular era. Oper Neurosurg (Hagerstown). 17(3):286-22. Sept 2019.

Raskin JS, Parnes M, Lam S. Progressive chorea and dystonia associated with a large arteriovenous malformation. Journal of the International Child Neurology Association. https://doi.org/10.17724/jicna.2019.154 Epub Oct 4 2019

Gadgil N, Lam S, Pyarali M, Paldino M, Pan IW, Dauser RC. Indirect revascularization with the dural inversion technique for pediatric moyamoya disease: a 20-year experience. J Neurosurgery Pediatr. 2018 Nov 1; 22(5):541-549.

MynxGrip vascular closure device use in pediatric neurointerventional procedures. Shokuhfar T, Hurley MC, Al-Smadi A, Ansari SA, Potts MB, Jahromi BS, Alden TD, Shaibani A.J Neurosurg Pediatr. 2018 May;21(5):466-470.

Al-Smadi A, Shokuhfar T, Johnston A, Alden TD, Bowman R, Shaibani A. The rare case of a large complex intraosseous cranial arteriovenous malformation with successful multidisciplinary management. J Neurosurg Pediatr. 2017 Dec;20(6):591-597.

Ghali MGZ, Srinivasan VM, Mohan AC, Jones JY, Kan P, Lam S. Pediatric Cerebral Cavernous Malformations: Genetics, Pathogenesis, and Management. Surgical Neurology International. 7(Suppl 44):S1127-34. Dec 2016.

Srinivasan VM, Gressot LV, Daniels B, Jones JY, Jea A, Lam S. Management of intracerebral hemorrhage in pediatric neurosurgery. Surgical Neurology International. 7(Suppl4):S1121-6. Dec 2016.

Hansen D, Kan P, Reddy GD, Mohan AC, Jea A, Lam S. Pediatric knowledge update: approach to the management of Vein of Galen aneurysmal malformations in neonates. Surgical Neurology International. 13;7(Suppl12):S317-321. May 2016.

Honarmand AR, Hurley MC, Ansari SA, Alden TD, Kuhn R, Syed FH, Shaibani A. Familial incidence of the congenital torcular dural arteriovenous shunt: Case report and review of the literature. Clin Neurol Neurosurg. 2016 May;144:129-32.

Honarmand AR, Hurley MC, Ansari SA, Alden TD, Kuhn R, Shaibani A. Focal stenosis of the sigmoid sinus causing intracranial venous hypertension: Case report, endovascular management, and review of the literature. Interv Neuroradiol. 2016 Apr;22(2):240-5.

Philanthropy

Your support is vital in helping us continue to make a difference in the lives of patients and families. Lurie Children's relies on philanthropic funding to enhance its programs, services and research for children. To learn more, please e-mail the Ann & Robert H. Lurie Children’s Hospital of Chicago Foundation at foundation@luriechildrens.org or call 312.227.7500

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