Pediatric Brain, Spine and Congenital Malformations

Congenital malformations of the brain and spine are problems with the nervous system that are present at birth. Some malformations are benign and don’t cause many symptoms, while others are more significant and require surgery to help prevent neurological complications. Our pediatric neurosurgeons work with a multidisciplinary team of specialists to coordinate care for children with these rare conditions.

The textbook of genetics was published out of Cedars‑Sinai for nearly 30 years and the institution has a long history of providing world-class care for a variety of children with congenital malformations of the brain and spine (including vascular malformations), genetic conditions and skeletal dysplasia.

Types of congenital brain and spine malformations

We treat a broad range of congenital brain and spine malformations, including:

• Arachnoid cysts: These are cysts that develop within one of the membranes covering the brain (arachnoid membrane), are filled with spinal fluid, and are frequently present at birth (a type of brain cyst).
• Chiari malformation: A malformation of the back of the brain that extends through the opening at the base of the skull into the cervical spine, which can block the normal flow of spinal fluid (hydrocephalus). In some children, this can result in multiple complications including increased pressure in the brain, cavitation of the spinal cord with damage to the spinal cord, and headaches.
• Encephalocele: A sac‑like bulge formed of brain tissue and spinal fluid extends through an abnormal defect in a child’s skull.
• Moyamoya disease: A small tangle of blood vessels develops after a larger blood vessel at the base of the brain (carotid artery) becomes blocked.
• Myelomeningocele: An atypical opening causes the spinal cord to develop outside the spinal canal.
• Spina bifida: Your baby’s spinal cord doesn’t develop properly before birth. Babies with spina bifida have a gap in their spine where spinal nerves are exposed.
• Tethered spinal cord: The spinal cord has abnormal attachment to tissue of the spinal canal and can’t move freely.

Our program is one of the few in Los Angeles able to assess and treat some of these conditions before your baby is born. Our Prenatal Diagnosis Center uses advanced testing and fetal imaging techniques that allow us to coordinate treatment quickly.

Diagnosis of congenital malformations often involves MRIs. Your child’s care team may use MRIs to get a close, detailed look at the bones and soft tissues in their brain and spine. These scans can also help guide us in creating an effective treatment plan.

We also use cardiac‑gated MRIs to assess cysts, which allow us to evaluate thin membranes that are otherwise difficult to see on a routine MRI. These images produce crisper, clearer images that help us meticulously plan surgery.

We treat brain, spine and congenital malformations using a multispecialty approach. Pediatric neurosurgeons, pediatric medical geneticists, neuroendovascular surgeons and other experts may work together to care for your child.

In mild cases, we may use “watchful waiting” to treat congenital malformations, where we schedule regular visits to monitor your child’s symptoms. Many children, however, require surgery.

Our renowned pediatric neurosurgeons and neuroendovascular surgeons offer multiple procedures to treat your child. They may perform surgeries to:

• Drain excess fluid
• Increase blood flow to the brain
• Release the spinal cord from spinal tissue
• Relieve pressure on the brain
• Remove cysts

After your child has surgery for a congenital malformation, consistent follow‑up care with their surgical team is crucial to monitor progress and recovery.

At Cedars‑Sinai, multiple specialists can help you and your family manage your child’s care, including:

• Child life specialists provide reassurance and calming activities when children are overwhelmed.
• Nurse navigators help you understand your child’s treatment, advise you on side effects and coordinate follow‑up appointments.
• Social workers connect you to community support groups, financial resources, transportation or housing needs.