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Not only does our brain and spinal cord tumor program take advantage of the expertise of our nationally renowned leaders in the field of neuro-oncology, it’s also able to utilize the most sophisticated techniques for surgical resection of tumors in even the most difficult locations, such as deep structures of the brain like the thalamus, or with tumors involving the very sensitive tissues of the spinal cord itself. Stereotactic Minimal Access Resection Technique (SMART surgery) was developed by Kerry Crone, professor of neurosurgery and director of the division of neurosurgery at Cincinnati Children’s, whereby computer guided navigation allows implantation of a special temporary balloon deep into the brain to create a tunnel that allows for the safe removal of certain deep-seated brain tumors. Our operating room BrainSUITE with intraoperative MRI facilitates this surgery by allowing the surgeon to readily ascertain the location of the tumor with unparalleled precision and assess the degree of resection during surgery if necessary. Our team of neurosurgeons, neuro-oncologists, pediatric neuroradiologists, pediatricians, critical care specialists, hospitalists, physical medicine and rehabilitation specialists, social workers and other support personnel work together in our family-centered care model to provide extremely sophisticated, yet always compassionate, care for our patients. Because many patients come from far away for the special medical and surgical treatments offered by the neuro-oncology brain and spine tumor program at Cincinnati Children’s, we’re pleased that the Ronald McDonald House, one of the largest in the country, on our campus is able to provide temporary housing for so many of our children and their families.
Approximately one in every 2,100 children is born with a condition called craniosynostosis. In this condition, usually for unknown reasons, some of the bony plates of the skull have fused along a natural suture line prior to birth, resulting in an abnormality in the shape of the child’s head. At times one can even feel a ridge, or bump, along the region of the skull where the premature fusion has taken place. Sometimes X-rays, including special three-dimensional CT scans, are done to assist in making this diagnosis and begin the process of surgical planning. Cincinnati Children’s is at the national forefront in limiting the amount of radiation exposure a child receives during such imaging, including CT scans. A diagnosis can usually be made readily by members of our craniofacial team using a combination of physical examination and imaging studies. In many cases, evaluation by a geneticist is part of the team evaluation because the disorder may be part of a syndrome that involves more than just the bony plates of the skull. Once a diagnosis of craniosynostosis has been made, our team of specially trained neurosurgeons and plastic surgeons can offer corrective surgery for these skull and facial deformities using a variety of techniques. When the condition is detected early, particularly if it involves only one suture of the skull, our neurosurgeons can often offer minimal access calvarial vault remodeling, whereby only small incisions are made, utilizing techniques that result in less blood loss and much shorter hospital stays than more traditional surgical approaches. Our surgical team of specialists also offers traditional correction of more extensive deformities of the face and skull associated with certain hereditary conditions such as Crouzon’s and Apert’s syndromes. Cincinnati Children’s has therapists who offer feeding and nutritional expertise as well as world renowned experts in the management of complex airway problems should your child require those specialties. Outcome analysis of surgical results with the new minimal access approaches shows that the skull remodeling is comparable to that with more traditional approaches utilizing more extensive operative interventions for many types of craniosynostosis. Your surgeons will discuss with you whether your child has a condition for which surgical correction could be considered and, if so, which type of surgery would be most appropriate.
> Read about the types of craniosynostosis repair.
Cincinnati Children’s offers the Comprehensive Epilepsy Center to evaluate and treat of children with epilepsy. Because 90 percent of new cases of epilepsy occur before the age of 20, and because the effects of chronic seizures can be so debilitating, our institution has made the treatment of children with this problem a high priority. While there are many new medications available for the treatment of epilepsy, about 5 percent to 10 percent of patients will continue to have frequent seizures despite the best medical therapy. For these patients, our neurosurgeons can offer a number of treatment options to help with seizure control ranging from the implantation of a vagal nerve stimulator to selective resection of the seizure focus in the brain, all the way to functional hemispherotomy, wherein one half of the brain is disconnected so that it becomes unable to generate seizure activity that can spread to the other side of the brain.
Children with intractable epilepsy undergo rigorous evaluation by a team of epileptologists and extensive noninvasive monitoring prior to a thorough individualized evaluation by the entire surgical team where all options for seizure control are discussed and presented.
Not only does Cincinnati Children’s have the largest and most active surgical epilepsy program for children in the region, it’s one of the largest such programs in the country. We utilize the most advanced imaging and neurophysiological monitoring techniques to assist with our surgical planning and decision-making, while continuously monitoring our outcomes to ensure the highest standards of care.
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