BLT Paediatric Neurovascular Collaboration Meeting – November 15, 2024 (London)

On Friday, November 15, 2024, the BLT Consortium gathered at the Great Ormond Street Institute of Child Health in London for a day of presentations, collaborative discussions, and international exchange. Experts from Boston (BCH/Harvard), London (GOSH), and Toronto (SickKids) came together to advance the understanding and treatment of rare pediatric neurovascular conditions.

The program combined cutting-edge research, clinical case insights, and collaborative brainstorming, reinforcing BLT’s mission to transform care for children worldwide.

BLT Paediatric Neurovascular Collaboration Meeting 2024 at Great Ormond Street Hospital, London

Morning Session: Advances in Classification, Stroke, and Moyamoya

The meeting opened with welcome remarks from Greg James (London), Ed Smith (Boston), and Peter Dirks (Toronto), followed by a series of expert talks:

• Ed Smith (Boston): Proposed a neurovascular taxonomy system for classifying rare conditions.

• Anoushka Alwis (London): Explored the role of oncogenes in vascular malformations.

• Samyami Chowdhury (Toronto): Shared insights from the hyperacute pediatric stroke pathway, emphasizing the importance of recognizing mimics.

• Alfred Pokmeng See (Boston): Addressed interventions for pediatric stroke, focusing on functional rehabilitation beyond structural lesions.

• Dulanka Silva (London): Presented a case series on metameric craniofacial AVMs alongside a systematic review of treatment strategies.

• Laura Lehman (Boston): Defined the concept of the “hungry brain” in Moyamoya disease, highlighting challenges in cerebral perfusion.

Afternoon Session: Research & Emerging Therapies

After a networking lunch, the meeting continued at the Wolfson Lecture Theatre, National Hospital for Neurology and Neurosurgery with deeper scientific insights:

• Invited Lecture: Prof. Paolo Tammaro (Oxford University) discussed regulation of cerebral microvascular blood flow by TMEM16A channels and its therapeutic implications.

• Darren Orbach (Boston): Examined whether brain AVMs are congenital or developmental, using incidence data in childhood.

• Charlotte Malcolm (London): Connected neuroimaging metrics with cognitive function in pediatric Moyamoya disease.

• Ed Smith (Boston): Updated on cavernous malformations, including guidelines from the Angioma Alliance and novel mechanistic targets.

• Greg James (London): Presented on intraoperative EEG in Moyamoya surgery and its predictive value for early postoperative TIAs and strokes.

• Peter Dirks (Toronto): Shared findings from the SickKids series on recurrent brain AVMs.

• Vijeya Ganesan (London): Discussed cerebral arteriopathy phenotypes in PHACES syndrome.

• Alfred Pokmeng See (Boston): Outlined evolving approaches to cerebral proliferative angiopathy (CPA) intervention.

The afternoon concluded with a challenging case discussion, encouraging open debate across institutions.

Networking & Collaboration

The day wrapped up with final remarks and thanks from Greg James and the London team, followed by a drinks reception at Queen Square and an evening social gathering at Sixes Cricket Fitzrovia. These informal sessions allowed for continued exchange and strengthened the consortium’s collaborative spirit.

Key Takeaways

• New frameworks are being developed to classify pediatric neurovascular conditions.

• Advances in stroke management and Moyamoya care are shaping treatment pathways.

• Cavernous malformations, CPA, and AVMs remain high-priority research areas.

• The meeting reinforced the value of cross-institutional collaboration in driving progress.