October 30th, 2013 | Migraines and other headaches aren’t just for grown-ups. Up to eight percent of children will experience a headache by the tender age of three. That number jumps to almost 50 percent by the time they reach seven. And puberty is prime time for the migraine to first rear its head. The good news is that in the vast majority of cases, headaches… Continue Reading
COMPLETE NEUROSURGICAL CARE
The neurosurgeons at Riley Hospital for Children at Indiana University Health provide all-inclusive services to treat brain, spinal cord and nervous system injuries, diseases and disorders in children that require surgery. Our neurosurgeons are fellowship trained and board certified, which means they all received extra training in order to become pediatric neurosurgeons.
Our extensive internal medicine services include:
|Spina Bifida||Cerebrovascular Malformations|
|Brain and Spinal Cord Disorders||Hydrocephalus|
|Congenital Spine Abnormalities||Spasticity|
|Chiari Malformations||Tethered Spinal Cord|
Moyamoya disease is a condition where the blood vessels at the base of the brain become blocked. Stroke may be the first symptom that appears in children with moyamoya disease. Additional symptoms may include transient ischemic attacks (sometimes called mini-strokes), seizures and headaches. Revascularization surgery is required to restore blood flow to the brain. Though the condition is rare, this surgery is performed quite often at Riley Hospital for Children at IU Health.
Some children who have seizures do not respond to medication as treatment. When that happens, the neurosurgery team, in conjunction with the neurology team, performs a comprehensive evaluation to determine if the child is a candidate for surgery. A number of tests are performed before deciding if the child is a good candidate for surgery. Surgery, when indicated, can result in children being cured of their seizures.
Spina bifida is a condition where the back bones, spinal cord, spinal nerves and fluid-filled sac that surrounds the spinal cord develop abnormally. The neurosurgeons at Riley at IU Health counsel the parents during the prenatal stage of development to prepare them for surgeries that may need to take place after birth. Surgery is required shortly after birth to repair the open defect and frequently to place a shunt to treat hydrocephalus (sometimes called “water on the brain”). Surgery may also be required later in life to release a tethered spinal cord, decompress a Chiari 2 malformation or revise a shunt.
The cerebrovascular system controls the blood supply to the brain. Cerebrovascular malformations include conditions like arteriovenous malformations (abnormal connections between veins and arteries in the brain or spinal cord), cavernous malformations (abnormally formed blood vessels in the brain or spinal cord), developmental venous angiomas (enlarged collection of veins) and malformations in the brain that cause bleeding. These conditions can be treated with surgery. If the child is not a candidate for surgery, stereotactic radiosurgery (radiation that focuses high-powered X-rays on specific areas of the body) may be an option.
Brain tumors and spinal cord tumors are masses of abnormal cells that have grown out of control. Sometimes the cells are benign (not cancer) and sometimes they are malignant (cancer). In most parts of the body, a benign tumor may never become life threatening. In the brain and spinal cord, however, benign tumors can pose a risk. If they grow, they can push on and destroy healthy parts of the brain or spinal cord. Our neurosurgery team may operate to remove brain and spinal cord tumors.
Hydrocephalus may be more commonly called “water on the brain.” This condition is caused by a buildup of cerebrospinal fluid (CSF) in the areas of the brain referred to as ventricles. This buildup of fluid causes pressure in the brain, which must be relieved. Hydrocephalus is typically treated either by inserting a shunt or performing an endoscopic third ventriculostomy (placing an opening in the floor of the third ventricle) to divert CSF away from the brain.
Some children are born with abnormally formed bones in their face and head. These abnormalities range from mild to severe and some require surgery. Common craniofacial malformations treated by our neurosurgeons include craniosynostosis (where the cranial sutures close too soon, hindering brain and skull growth) and hemangiomas (tumors composed of blood vessels that may cause skin pigmentation or birthmark).
Riley at IU Health is a level 1 trauma center, which means we are equipped to provide the highest level of surgical care to all trauma patients. When patient injury or trauma involves the brain, spinal cord or nervous system, our neurosurgeons provide care to these patients.
Congenital spine abnormalities encompass a number of conditions where the spine develops abnormally. They can include spina bifida, tethered spinal cords, lipomyelomeningoceles (a fatty mass located under the skin and near or around the spinal cord), neurenteric cysts, split cord malformations, butterfly vertebra or hemivertebrae (abnormally shaped vertebrae), and scoliosis (abnormal curvature of the spine). These conditions typically present at birth or shortly after birth. Surgery may be needed to release a tethered spinal cord (the spinal cord is attached abnormally to spine tissue) or repair an open or closed neural tube defect.
Spasticity includes disorders that cause stiff or tight muscles, lack of muscle control, and overactive reflexes. Spasticity may result from severe brain or spinal cord injury, cerebral palsy, or multiple sclerosis. Spasticity can cause pain and body deformation. Surgery may be used to implant a device to deliver antispasticity medication, like a baclofen pump. Other surgical options include dorsal rhizotomy, a surgery used to destroy nerve roots, which may help relieve some spastic conditions.
A chiari malformation is a brain defect that affects the structure of the cerebellum, the part of the brain that controls balance. In children with Chiari malformation, the cerebellar tonsils extend into the spinal canal, causing many symptoms including headaches, occipital headaches (pain in the back of the head), neck pain, balance problems, vision problems, double vision, nystagmus (involuntary, rapid, repetitive eye movement), problems with coordination, swallowing difficulty, gagging, stridor (high-pitched wheezing) and apnea (pauses in breathing). Surgery is used to decompress the Chiari malformation and relieve symptoms.
A tethered spinal cord means that the spinal cord is abnormally attached to spine tissue. This attachment may cause tension on the spinal cord especially during growth spurts. Some children need to have surgery early in order to prevent long-term complications, stop further deterioration and prevent disability that the tether may cause.