Significant Accomplishments
Deep Brain Stimulation
The Division of Pediatric Neurosurgery, headed by Kerry Crone, MD, will launch a program in deep brain stimulation. Ellen Air, MD, will join the staff this year to develop a program that will focus on children with complex movement disorders and pain. Cincinnati Children’s will be the first major pediatric center to offer this treatment.
Understanding Seizures, Hydrocephalus
Francesco Mangano, DO, directs the Surgical Epilepsy Program. Collaborating with the Pediatric Neurology Division, it is one of the few national centers offering a surgical option for children with treatment-resistant epilepsy. The program focuses on advanced methods to identify and subsequently resect the precise location of seizure origin in the brain. The goal is to eliminate or significantly reduce the number of seizures. For many young patients, the treatment has taken them from frequent daily seizures to seizure freedom or managing fewer episodes with minimal medication. During this past year, the program has grown and has published highly favorable outcomes.
Using diffusion tensor imaging (DTI), Mangano and colleagues continue researching how to predict outcomes for children with hydrocephalus based on pre- and post-treatment MR diffusion properties. Their work is funded by the National Institute of Neurological Disorders and Stroke. Mangano’s investigation into hydrocephalus earned the research team a National Student Research Forum Neuroscience Award and the Ohio State Neurosurgical Society Resident Award in 2010-2011. Mangano worked with a neurosurgeon from China who was a visiting professor at Cincinnati Children’s. The focus was to collaborate and implement an epilepsy program in China. This year further research funding was secured through an industry grant.
New Craniofacial Team
Todd Maugans, MD, directs the neurosurgical craniofacial team. He is engaged in the formation of a Craniofacial Center at Cincinnati Children’s. He has presented his experiences with minimally invasive craniosynostosis techniques and the intraoperative use of medications to limit blood loss at national and international meetings, as well as in publications including the Journal of Craniofacial Surgery. His manuscript describing cutaneous anomalies associated with spina bifida was awarded an editor’s choice distinction in the prestigious journal of Neurosurgery. He recently completed an investigation of pediatric sports-related concussion injury.
Improved Cerebral Palsy, Spina Bifida, Tumor Care
Charles Stevenson, MD, working closely with physicians in the multidisciplinary Cerebral Palsy Program, has broadened the range of surgical treatment options for children with debilitating spasticity. Following comprehensive evaluation, children may be candidates for either intrathecal baclofen therapy or selective dorsal rhizotomy (SDR), a technique of reducing spasticity in the legs in which abnormally functioning nerve roots are identified and sectioned.
Stevenson and colleagues in the Fetal Care Program began performing in utero repair of myelomeningocele defects this year, following release of data from the NIH-sponsored Management of Myelomeningocele Study (MOMS) in February 2011 that demonstrated that fetal repair of spina bifida defects substantially reduces the chance that children will require placement of a shunt for hydrocephalus. Several fetal repairs have already been performed here, with highly favorable outcomes.
Utilizing a novel fluorescent compound engineered to selectively bind and label brain tumor cells, Stevenson is researching ways to make tumors “glow” in the operating room, thereby making it easier for surgeons to safely remove tumors in their entirety while sparing and protecting adjacent healthy brain matter. Such techniques, while enhancing the safety of brain tumor surgery, may potentially facilitate complete resection of tumors, leading to higher cure rates and fewer recurrences.
