Chiari Malformation
Overview:
Chiari malformation happens when part of the lower brain sits too low and pushes into the spinal canal. This can block the flow of cerebrospinal fluid (CSF) and cause headaches, neck pain, and neurological symptoms. Some people are born with it and do not notice symptoms until later in life.
Common Symptoms:
- Headaches, often worse with coughing or straining
- Neck pain
- Balance problems or dizziness
- Numbness or tingling in the hands
- Trouble swallowing
- Ringing in the ears
Treatments & Procedures:
- MRI with CSF flow studies
- Chiari decompression surgery
- Duraplasty when needed to improve CSF flow
- Pain and symptom management for mild cases
- Monitoring when symptoms are stable
Congenital Intracranial Cysts
Congenital Intracranial Cysts
Overview:
Congenital intracranial cysts are fluid-filled sacs that form in the brain before a baby is born. Some cysts cause no problems and are found by chance. Others can grow or press on nearby brain tissue and may need treatment.
Common Symptoms:
- Enlarged head size in infants
- Headaches
- Nausea or vomiting
- Seizures
- Developmental delays
Treatments & Procedures:
- Monitoring with imaging when no symptoms are present
- Cyst drainage to remove excess fluid
- Endoscopic surgery to create fluid pathways
- Shunt placement to redirect fluid when needed
Craniosynostosis
Overview:
Craniosynostosis is when one or more bones in a baby’s skull close too early. This can change the shape of the head and may cause pressure on the brain as it grows. The cause is sometimes genetic, but often it happens without a clear reason.
Common Symptoms:
- An unusually shaped head
- Slow or uneven head growth
Treatments & Procedures:
- Cranial remodeling surgery: Reshapes the bones of the skull to allow the brain to grow normally
- Minimally invasive surgery: A less invasive option for some babies, followed by helmet therapy
- Helmet therapy: Helps guide the head into a more typical shape after surgery
Dermal Sinus Tract and Tethered Cord
Dermal Sinus Tract and Tethered Cord
Overview:
A dermal sinus tract is a small tunnel in the skin that can connect to the spinal canal. It forms before birth and can lead to infection or spinal cord problems. Tethered cord occurs when the spinal cord is abnormally attached, limiting movement as a child grows.
Common Symptoms:
- Small dimple or opening on the back
- Repeated infections
- Back or leg pain
- Weakness or numbness in the legs
- Bladder or bowel changes
Treatments & Procedures:
- Surgical removal of the dermal sinus tract
- Spinal untethering surgery to free the spinal cord
- Imaging and long-term follow-up
Hydrocephalus and Congenital CSF Disorders
Hydrocephalus and Congenital CSF Disorders
Overview:
Hydrocephalus happens when too much cerebrospinal fluid (CSF) builds up in the brain. In children, this is often present at birth or develops early in life. Extra fluid can increase pressure in the brain and affect growth and development.
Common Symptoms:
- Rapid head growth
- Bulging soft spot on the head
- Vomiting
- Sleepiness or irritability
- Developmental delays
Treatments & Procedures:
- VP, VA, VPl, or LP shunt placement to drain extra fluid
- Endoscopic third ventriculostomy (ETV), a procedure that creates a new fluid pathway
- Ongoing imaging and follow-up care
Myelomeningocele and Congenital Spine Anomalies
Myelomeningocele and Congenital Spine Anomalies
Overview:
Myelomeningocele is a severe form of spina bifida where part of the spinal cord and nerves develop outside the body. It forms early in pregnancy and can affect movement, bladder control, and sensation. Other congenital spine anomalies may affect the shape or function of the spine and spinal cord.
Common Symptoms:
- Visible opening or sac on the back at birth
- Weakness or paralysis in the legs
- Bladder or bowel control problems
- Orthopedic issues, such as foot deformities
Treatments & Procedures:
- Surgical closure of the spinal opening
- Spinal untethering surgery to release tension on the spinal cord
- Shunt placement if hydrocephalus is present
- Ongoing care with a pediatric specialty team
Pediatric Brain Tumors
Overview:
Pediatric brain tumors are abnormal growths that form in a child’s brain or spinal cord. These tumors can be non-cancerous or cancerous and may affect how a child grows, moves, thinks, or feels. The cause is often unknown, though some may be linked to genetic conditions. Tumors may grow slowly or quickly, depending on the type.
Common Symptoms:
- Headaches, especially in the morning
- Trouble with balance, vision, or behavior
Treatments & Procedures:
- Surgery: Removes as much of the tumor as safely possible
- Chemotherapy: Uses medicine to kill or shrink tumor cells
- Radiation therapy: Uses targeted energy to treat the tumor (used carefully in children)
- Shunt placement: May be needed if the tumor causes fluid buildup in the brain
- Rehabilitation: Physical, speech, or occupational therapy may help with recovery
Spasticity
Overview:
Spasticity is a condition that causes stiff or tight muscles. It happens when the brain or spinal cord cannot properly control muscle movement. In children, spasticity is often linked to neurological or congenital conditions.
Common Symptoms:
- Muscle stiffness or tightness
- Difficulty moving arms or legs
- Muscle spasms
- Delayed motor development
Treatments & Procedures:
- Physical and occupational therapy
- Oral medications to relax muscles
- Intrathecal baclofen pump therapy, which delivers medication directly to the spinal fluid
- Selective neurosurgical procedures to reduce muscle stiffness
Syringomyelia
Overview:
Syringomyelia is a condition where a fluid-filled cavity (called a syrinx) forms inside the spinal cord. It often develops from Chiari malformation but can also follow injury, infection, or spinal surgery. As the syrinx grows, it can damage nerves and affect movement and feeling.
Common Symptoms:
- Neck or back pain
- Weakness in the arms or hands
- Loss of feeling, especially temperature changes
- Stiffness in the arms or legs
- Worsening balance
Treatments & Procedures:
- MRI to monitor syrinx size
- Chiari decompression surgery (if the syrinx is caused by Chiari)
- Syrinx drainage or shunt (in select cases)
- Treatment of the underlying cause
We've highlighted some of the most common services—please explore the conditions list for treatments by condition.
Chiari Decompression Surgery
Chiari Decompression Surgery
Overview:
Chiari decompression reduces pressure at the base of the skull where the brain meets the spine. Removing a small amount of bone and, in some cases, opening the dura helps restore normal cerebrospinal fluid (CSF) flow and relieve symptoms.
Conditions Treated:
- Chiari Malformation Type I
- Chiari-related headaches and neck pain
- Chiari-related syringomyelia
Before the Procedure:
MRI with CSF flow studies helps plan the surgery. Your surgeon will explain the steps and discuss anesthesia and recovery. You may need to stop certain medicines ahead of time.
After the Procedure:
Most patients stay several days in the hospital. Neck soreness is common at first. As healing continues, headaches, balance problems, and other symptoms often improve. Follow-up imaging may be needed.
Cranial Vault Remodeling
Overview:
Cranial vault remodeling surgery (open and endoscopic) is used to correct the shape of a baby’s head when skull bones close too early. The procedure creates more space for the growing brain and improves head shape and symmetry.
Conditions Treated:
- Craniosynostosis
- Abnormal head shape in infants
Before the Procedure:
Imaging and physical exams help confirm the diagnosis and guide planning. Instructions may include pre-op blood tests and guidance on feeding before surgery.
After the Procedure:
Children stay in the hospital for a few days. Recovery may include wearing a helmet, if needed, and follow-up visits to monitor healing and skull growth.
Endoscopic Third Ventriculostomy
Endoscopic Third Ventriculostomy
Overview:
Endoscopic third ventriculostomy (ETV) is a minimally invasive procedure that creates a new pathway in the brain to allow fluid to flow and relieve pressure. It’s often an alternative to shunt placement.
Conditions Treated:
- Hydrocephalus
- Blocked fluid pathways in the brain
Before the Procedure:
Children will need an MRI or other imaging to confirm they are a candidate for ETV. Instructions may include stopping food or drink before surgery.
After the Procedure:
Most children recover in the hospital for one or two days. Follow-up imaging helps confirm that fluid is draining properly and symptoms are improving.
Intracranial Pressure Monitoring
Intracranial Pressure Monitoring
Overview:
Intracranial Pressure Monitoring measures the pressure inside the skull using a small sensor. This helps diagnose pressure disorders or guide treatment for cerebrospinal fluid (CSF) flow problems.
Conditions Treated:
- Suspected CSF pressure disorders
- Hydrocephalus with unclear symptoms
- Conditions affecting brain swelling or fluid balance
Before the Procedure:
Imaging helps guide placement. The sensor is placed during a short procedure under anesthesia. Monitoring may continue for a day or longer.
After the Procedure:
You will remain in the hospital while the care team tracks pressure changes. The sensor is removed once testing is complete. Results guide your treatment plan.
Intrathecal Baclofen Pump Therapy
Intrathecal Baclofen Pump Therapy
Overview:
This pump delivers medicine directly into the spinal fluid to relax tight muscles. It is used for severe spasticity when oral medicines do not help enough.
Conditions Treated:
- Spasticity from spinal cord injury
- Spasticity from brain injury or stroke
- Spasticity from multiple sclerosis
Before the Procedure:
A test dose is given first to see how well your body responds. If the test works, a small pump is placed under the skin during surgery. You will receive instructions about medicines and activity before the procedure.
After the Procedure:
You may stay in the hospital for monitoring. The pump needs regular refills and adjustments. Many people notice smoother movement and fewer spasms.
Ommaya Reservoirs for Neonates
Ommaya Reservoirs for Neonates
Overview:
An Ommaya reservoir is a small device placed under the scalp that allows doctors to safely access fluid around the brain. In neonates, it is often used to manage fluid buildup or deliver medication without repeated needle sticks. The reservoir connects to the brain’s fluid spaces and is placed by a neurosurgeon.
Conditions Treated:
- Hydrocephalus in newborns
- Intraventricular hemorrhage
- Conditions requiring repeated CSF sampling or medication delivery
Before the Procedure:
Before surgery, imaging helps guide placement of the reservoir. The care team reviews the baby’s condition and explains the procedure to parents or caregivers. The surgery is performed under anesthesia to ensure the infant is comfortable and safe.
After the Procedure:
After placement, the reservoir can be accessed through the skin using a small needle when needed. Babies are monitored closely for healing and infection. Many infants benefit from fewer procedures and improved fluid management while the care team plans next steps.
Pediatric Tumor Resection (for Brain, Skull, and Spine)
Pediatric Tumor Resection (for Brain, Skull, and Spine)
Overview:
Pediatric tumor resection is a surgery to remove as much of a brain or spinal tumor as safely possible. This procedure helps relieve pressure, reduce symptoms, and guide further treatment such as therapy or monitoring.
Conditions Treated:
- Pediatric brain tumors
- Spinal tumors in children
Before the Procedure:
Children usually have imaging studies, such as an MRI, to locate the tumor and plan the surgery. Your care team will discuss anesthesia, fasting, and medications ahead of time.
After the Procedure:
Most children stay in the hospital for monitoring and recovery. Follow-up visits may include imaging, physical therapy, or additional treatments, depending on the tumor type and location.
Shunt Placement (VP, VA, VPl, LP)
Shunt Placement (VP, VA, VPl, LP)
Overview:
Shunt placement is a surgical procedure used to treat excess fluid around the brain or spinal cord. A shunt is a thin, flexible tube that helps drain extra cerebrospinal fluid (CSF) to another part of the body, where it can be absorbed safely. Neurosurgeons choose the type of shunt based on a patient’s age, condition, and overall health.
Conditions Treated:
- Hydrocephalus
- Normal pressure hydrocephalus
- Congenital brain and CSF disorders
- CSF flow obstruction
- Increased pressure in the brain
Before the Procedure:
Before surgery, imaging tests such as MRI or CT scans are done to confirm fluid buildup and plan shunt placement. Your care team will review medications and medical history. Most patients are admitted to the hospital on the day of surgery, and anesthesia is used to keep you comfortable.
After the Procedure:
After shunt placement, patients are closely monitored in the hospital. Imaging may be done to confirm the shunt is working properly. Recovery time varies, but many patients notice symptom relief as pressure decreases. Follow-up visits help ensure the shunt continues to function well over time.
Spinal Untethering Surgery
Spinal Untethering Surgery
Overview:
Spinal untethering surgery treats a condition where the spinal cord is abnormally attached to the surrounding tissue. This tension can limit movement of the spinal cord and cause pain or nerve problems as a child grows. The goal of surgery is to release the cord and allow it to move freely.
Conditions Treated:
- Tethered cord syndrome
- Spina bifida
- Congenital spinal cord abnormalities
Before the Procedure:
Before surgery, imaging tests such as MRI help confirm tethering and guide treatment planning. Your neurosurgeon will explain the risks and benefits of surgery. Patients are admitted to the hospital, and general anesthesia is used.
After the Procedure:
After surgery, patients rest in the hospital while healing begins. Activity may be limited for a short time to protect the spine. Many patients experience improvement in pain, movement, or bladder symptoms. Follow-up visits help monitor recovery and long-term outcomes.
Syrinx Drainage or Shunting
Syrinx Drainage or Shunting
Overview:
When a syrinx (fluid-filled cavity in the spinal cord) causes symptoms, a small drainage tube or shunt may be placed to help fluid flow. This reduces pressure inside the spinal cord.
Conditions Treated:
- Syringomyelia
- Syrinx from Chiari malformation
- Syrinx from injury or infection
Before the Procedure:
Imaging is used to locate the syrinx and guide planning. Your care team will explain anesthesia, surgical steps, and expected recovery.
After the Procedure:
Neck or back soreness is common for a few days. Symptoms like weakness or numbness may improve over time as pressure decreases. Follow-up imaging checks the syrinx size and stability.
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