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Rady Children's Specialists

Neurosurgery

Vascular Lesion Program

Giant middle cerebral artery aneurysm in a 3-month-old cured by primary clip ligation.

The Vascular Lesion Program provides a comprehensive treatment approach to complex vascular lesions, including pediatric brain aneurysms and arteriovenous malformations (AVMs).

Aneurysms refer to a weakness in an artery causing a protruding, bulging bubble-like or pouchlike abnormality involving vascular complexities. The reason can be genetic, induced as a result of other primary abnormalities, infectious, or idiopathic (with unknown cause) in nature. Most aneurysms in the brain appear in the space between the brain and its surrounding tissue, known as subarachnoid space, and can cause subarachnoid haemorrhage. A subarachnoid hemorrhage is a medical emergency and may lead to permanent brain damage or death if not treated promptly.

Arteriovenous malformations are a tangle of abnormal blood vessels (arteries and veins) and occur most commonly in the brain. In patients with an AVM, blood flowing at high pressure through the arteries pumps directly into the veins rather than passing (as it should) through a bed of tiny vessels (capillaries), which nourish the brain tissue and reduces the pressure of the blood entering the veins. Eventually, the consistently high-pressure blood flow through the AVM can cause the vessels to expand, potentially causing an aneurysm.

At Rady Children’s, pediatric vascular lesions are treated by a highly skilled and multidisciplinary team, including renowned specialists in neurosurgery, plastic and craniofacial surgery, diagnostic imaging and interventional radiology, laser surgery, genetics, orthopedics, otolaryngology, ophthalmology and dermatology.

Intracranial and intraspinal lesions are treated by a combination of interventional, surgical and stereotactic radiosurgical approaches.

Surgical interventions include intra-operative CT angiography, intraoperative angiography (with or without concurrent embolization), frameless stereotaxy, thermal imaging and cardiac standstill.

Team

Michael Levy, M.D., Ph.D., Division Chief, Neurosurgery

Dr. Levy  is a leader in the field of employing innovative surgical simulation techniques (like preoperative, 3D virtual and stereolithographic modeling) to improve patient outcomes from vascular lesion surgery.

Alexander Khalessi, M.D., M.B.A., M.S., Director, Pediatric Endovascular Neurosurgery Program

Dr. Khalessi is one of the nation’s leading practitioners of minimally invasive techniques for brain aneurysms, brain arteriovenous malformations, intracranial and extracranial vascular disease, and minimally invasive spine interventions.

Lawrence F. Eichenfield, M.D., Director, Vascular Lesion and Birthmark Center

Dr. Eichenfield is a nationally renowned pediatric dermatologist and expert in treating vascular skin lesions.