Current Environment:

Multicenter research

Research
  • Fetal Embolization for Vein of Galen Malformation: Our multidisciplinary team has developed a novel approach for intervention in utero for vein of Galen malformation, in order to prevent the most severe clinical manifestations after birth. An IRB- and FDA-approved clinical trial of this treatment is underway at Boston Children’s.
  • Human Genetics and Molecular Mechanisms of Vein of Galen Malformation: A multicenter study of the genetics of intracranial vascular malformations.
  • Modifiers of Disease Severity in Cerebral Cavernous Malformations: A six-center study examining the modifiers of disease progression in cerebral cavernous malformation.
  • Advanced Neuroimaging Techniques for the Evaluation of Cerebrovascular Disease: Approaches such as quantitative flow imaging, perfusion imaging, ultra-high field MRI (7T), and diffusion tractography are being refined and used for brain imaging in infants and children, and fetuses as well as in placentas to help understand the development and natural history of conditions such as moyamoya, vein of Galen malformation, cerebral proliferative angiopathy, and others. Look at the impact of preoperative imaging on surgical decision-making.
  • Diffusion-Weighted MRI Demonstrates White Matter Alterations in Watershed Regions in Children With Moyamoya Without Stroke or Silent Infarct: A study addressing the concern of unrecognized white matter injury in children with moyamoya.

Fetal Treatment of Galenic Malformations

Working with specialists from Boston Children’s Maternal Fetal Care Center in affiliation with Brigham and Women’s Hospital, we’re conducting a clinical trial on fetal intervention for vein of Galen malformation.

Imaging, 3D printing, moyamoya surgery endovascular techniques

3D printing to model brain and vascular anatomy

Center directors Edward Smith, MD, and Darren Orbach, MD, PhD, are working with Peter Weinstock, MD, PhD, and others at Boston Children’s to create 3D models of patients’ brains and blood vessels using the data from their brain scans to plan and rehearse surgical and neurointerventional maneuvers in advance of surgery.

Surgical treatments for cerebrovascular disease

Our neurosurgical team has developed surgical treatments for pediatric cavernous malformations. For children with moyamoya disease, we developed an operation known as pial synangiosis, which stimulates new blood vessels to grow in the brain and has been shown to be safe and effective in reducing stroke risk in children with moyamoya disease.

Biomarkers for cerebrovascular disorders

CSIC director Edward Smith, MD, is identifying biomarkers in patient urine that may help diagnose and monitor CVD, reducing the need for children to travel to Boston Children’s for follow-up imaging. Dr. Smith has already validated the effectiveness of urine biomarkers for several kinds of brain tumors.

Cerebrovascular disease database

Our comprehensive and dynamic patient database is one of the largest studies of pediatric cerebrovascular disease globally and provides continuous source material for ongoing studies. The data allows us to track long-term patient outcomes, compare the results of surgical and neurointerventional procedures, evaluate newly adopted interventions, and improve our quality of care.

Practice advances

Our physicians have authored AHA guidelines for AVM and AHA guidelines for moyamoya disease, and have played a key role in developing the current American Heart Association (AHA) guidelines for stroke management in children.