IMFH | Maternal-Fetal Services | Physician Services | Neurosurgery
IMFH’s medical staff includes board-certified neurosurgeons, neurologists, neuroradiologists, neuropathologists, neuro-oncologists, neuro-ophthalmologists, radiation therapists, psychologists, rehabilitation therapists and clinical nurse specialists. Together, this team of specialists works to provide the best possible outcomes for babies who may require neurosurgery. IMFH’s neurosurgical services include:
Brain and Spinal Cord Tumors: Optimal treatment of brain tumors requires a sophisticated, coordinated multidisciplinary treatment approach. Armed with the latest technical equipment, IMFH’s Neurosurgery team provides advanced surgical solutions, with outcome statistics that match or exceed any other program in the United States and beyond.
Arachnoid Cysts: Modern imaging techniques have revolutionized our ability to diagnose and treat central nervous system (CNS) problems. This includes arachnoid cysts, which can cause raised intracranial pressure or impairment of cerebral spinal fluid (CSF) pathways to produce hydrocephalus. Our neurosurgeons have extensive experience treating such cysts of the brain and spinal cord. When possible, we try to treat the cyst with fenestration before resorting to CSF diversion by shunting techniques.
Vascular Malformations: Although uncommon, arteriovenous malformations (AVM) and aneurysms can cause life-threatening and/or devastating neurologic impairment following hemorrhage. Our ability to treat these lesions by direct surgical approach or endovascularly has been enhanced by the availability of magnetic resonance imaging (MRI) and magnetic resonance angiography. In addition, neuroradiologists and anesthesiologists can properly and safely sedate patients, contributing to patient comfort and superior imaging studies. We employ intraoperative angiography to assure that the AVM has been completely excised or that the aneurysm has been properly clipped.
Craniosynostosis and Craniofacial Reconstruction: Craniosynostosis can vary from involvement of a single suture, such as the sagittal, to multiple sutural involvement, such as Apert and Crouzon Syndromes. If only the calvarium (upper skull) is involved and surgery is required, the neurosurgical team will correct the problem. If the face is involved, then the full craniofacial team will participate.
Hydrocephalus: Hydrocephalus is one of the most common problems faced in pediatric neurosurgery and can impact pre-term infants who develop hydrocephalus associated with intraventricular hemorrhage. Patients are carefully evaluated for cerebral spinal fluid (CSF) diversion, which is undertaken only if absolutely necessary. We believe the best way to avoid shunt problems is to not insert a shunt. Our physicians insert or revise approximately 300 shunts a year.
Neural Tube Defects: The most common form of neural tube defect (NTD) is open, specifically the myelomeningocele or spina bifida. In this lesion, the spinal cord is exposed and often cerebral spinal fluid (CSF) is leaking. Lesions are usually repaired shortly after birth, but can also be repaired in utero. Nearly all patients require a CSF-diverting shunt and have multiple problems, including extensive CNS involvement, varying degrees of motor/sensory deficit in the lower extremities and a neurogenic bladder and bowel. A diverse group of pediatric specialists and ancillary providers devise a comprehensive, ongoing program to maximize the potential of children with varying degrees of neurologic deficit. In addition to open NTD, some infants are born with a closed NTD or spinal dysraphism. This includes infants with lipomatous malformation (lipomyelomeningocele), congenital dermal sinuses (with dermal inclusion cysts), split cord malformation (diastematomyelia) and other uncommon types of closed NTDs, such as myelocystoceles and neuroenteric cysts, most of which can be classified under the tethered spinal cord syndrome. Our goal is to decompress or untether the spinal cord to prevent progressive neurologic deficit that can evolve over the course of months to years to decades. We treat these patients in conjunction with the orthopaedic surgeons and urologists, as needed.
