Pediatric Neurosurgery

Achondroplasia is the most common form of human short-limbed dwarfism, and our pediatric neurosurgeons are experts on treating children with achondroplasia who have hydrocephalus, cervicomedullary compression and spinal stenosis. The team at Hasbro Children’s Hospital includes both pediatric neurosurgical experts and pediatric orthopedic spine experts who work together to offer families with achondroplasia a multidisciplinary team approach.

Arachnoid cysts are cerebrospinal fluid-filled cysts that develop in the brain and can cause neurologic symptoms as a result of their size or location; they may also be discovered incidentally. Many patients with arachnoid cysts never need surgery. If necessary, treatment options include shunting. Our pediatric neurosurgeons will evaluate each patient and their studies and make recommendations based on careful review and discussion with the patient and their families.

Close to 2,000 children in the U.S. are diagnosed with a brain tumor each year—ranging from malignant tumors that can be aggressive to benign tumors that are much slower growing. The team at Hasbro Children’s Hospital includes specialists in surgery, radiation therapy and chemotherapy for pediatric brain tumors. The multidisciplinary team shares the care of each patient and family with the goal of the best long term outcome for each child, while also offering peace of mind to family members.

Children with cerebral palsy often develop spasticity as a result of their birth injury. This can affect a child’s quality of life and make it difficult for their caregivers to assist with basic daily activities. At Hasbro Children’s Hospital, multidisciplinary pediatric neurosurgery and neurology teams work closely to offer the most advanced treatments available to treat the spasticity associated with cerebral palsy.

A Chiari malformation is a problem with how the area in the back of the head forms. The lower part of the cerebellum should lie “freely” at the base of where the skull meets the neck. In a Chiari malformation, this part of the cerebellum is squeezed at the base of the skull along with the brain stem and spinal cord. This can cause headaches or other neurologic symptoms. Chiari can sometimes also be associated with a cystic dilation of the spinal cord, called a syrinx. The pediatric neurosurgery team at Hasbro Children’s Hospital has expertise in the treatment of both children and adults with Chiari.

A baby’s skull is not one bone but several bony plates that meet up and connect at sutures. Most of the head’s growth occurs in the first 2 years of life and this growth occurs at the suture. When the head is done growing, the suture closes. If a suture closes too early, it is called craniosynostosis. This occurs in about one of every 2,000 live births.

Craniosynostosis causes the head shape to be deformed and can prevent the brain from having enough room to grow. Treatment for craniosynostosis at Hasbro Children’s Hospital is given by an experienced team that includes neurosurgeons and craniofacial plastic surgeons. The goal of surgery is to safely give the brain the room it needs to grow and return the head shape to normal. There are several different types of craniosynostosis depending on the suture affected and some of these can be associated with different genetic syndromes. The craniofacial team will discuss all of this with you on your visit to Hasbro Children’s Hospital.

For most children with epilepsy, it is well-controlled by medication with few limitations, but for those children who experience uncontrolled seizures despite aggressive antiepileptic treatment, epilepsy surgery is often considered. Surgical removal of the “epileptic zone” can mean a cure for many patients. Our team of neurologists and neurosurgeons, all experts in the treatment of children with epilepsy, meet and discuss each surgical candidate and all the possible surgical and nonsurgical treatment options.

Learn more about Rhode Island Hospital's Comprehensive Epilepsy Program

The body produces and absorbs cerebrospinal fluid, the fluid that bathes your brain and spinal cord, every day. When there is a blockage in the absorption of cerebrospinal fluid, the buildup of fluid is called hydrocephalus—a dangerous condition that can be fatal. Treatments for hydrocephalus include shunting and endoscopic third ventriculostomy. Both options are considered for every child at Hasbro Children’s Hospital.

Treatment for children with hydrocephalus routinely includes:

• the use of programmable shunts to significantly reduce the rate of shunt failures
• quick scan MRI that avoids the use of sedation or exposing children to radiation
• low infection rate
• endoscopic techniques that merge stereotactic navigation and intraoperative CT

Spinal cord tumors in children are rare, but when they do occur, they can be treated very effectively by an experienced surgical team at Hasbro Children’s Hospital. Minimally invasive techniques, intraoperative ultrasound and CT, and frameless stereotactic navigation are all surgical technologies available in the Hasbro Children’s Hospital neurosurgical operating room to make the surgical treatment of spinal cord tumors as precise and effective as possible.

A child born with spina bifida has an incompletely formed spinal cord that is exposed to the air. Surgery can resolve this defect. Other surgical concerns associated with spina bifida are possible diagnoses of Chiari, syringomyelia, and hydrocephalus. Mothers with prenatal ultrasound diagnoses of spina bifida are referred to our prenatal team of high risk obstetricians, neurologists, neurosurgeons, and urologists. The treatment of spina bifida requires a team of doctors working together at Hasbro Children’s Hospital.

The spinal cord ends and divides into small nerve roots at the second lumbar vertebral body. If fat, scar, or any tissue element is attached to the neural tissue as a child grows, the spinal cord can be put under tension, or become “tethered." Tethering can cause pain, weakness or problems with urination. Untethering the spinal cord must be resolved surgically. At Hasbro Children’s Hospital, a team of surgeons that include pediatric urologists, neurosurgeons, and orthopedic spine surgeons all care for patients with tethered spinal cords. Intraoperative nerve monitoring is performed to protect the nerves during surgery.

Vascular malformations in children may, in some cases, be life threatening. Surgery, gamma knife radiosurgery, and endovascular treatment are all available at Hasbro Children’s Hospital to treat these complex cases. Here, the care of children with vascular abnormalities is coordinated between a team of pediatric neurosurgeons, pediatric anesthesiologists, and pediatric intensive care specialists.