Neurosurgery

Brain Tumors and spinal cord tumors

The diagnosis of a brain tumor in one’s child can be a frightening and overwhelming experience. The pediatric neurosurgeons at Children’s hospital of San Antonio have extensive training and expertise in the management and surgical treatment of children with brain tumors. Not all tumors are malignant, and some can be cured with surgery, alone. We work closely with our radiologists, oncologists, and pathologist to individualize and optimize treatment for each child diagnosed with a brain tumor. Support is also available to families who are dealing with the diagnosis.

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Chiari malformation

Chiari malformation is when the back of the brain (the cerebellar tonsils) is descended below the base of the skull. Presenting symptoms vary, but include headaches (commonly at the back of the head), dizziness, balance problems, numbness, choking, swallowing difficulties, sleep apnea, and scoliosis. The extent or severity of this condition is variable, and therefore not everyone would require surgery. Those who have symptoms that are progressive and severe can only be treated with surgery. The surgery involves decompressing the back of the brain and placing a patch graft over the covering of the brain and spinal cord.

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Craniosynostosis

Craniosynostosis is the premature closure of one or more cranial vault sutures, resulting in deformation of the skull and sometimes the face. As the brain grows, this restriction of growth can cause increased intracranial pressure, which can manifest with developmental delay, headaches, or vision loss. Although early diagnosis is best, we can treat most cases of craniosynostosis at any age, from infants to teens. Innovative technologies are employed to provide optimal results. Our neurosurgeons are part of a craniofacial team, consisting of plastic surgeons, dentists, and social workers, to provide comprehensive care for patients with craniosynostosis.

Hydrocephalus

Our pediatric neurosurgeons diagnose, manage and treat hydrocephalus. Hydrocephalus is the abnormal accumulation of cerebrospinal fluid (CSF) in the brain, which can result in increased pressure. Treatment options include a shunt, endoscopic fenestration, or endoscopic third ventriculostomy. Each case is individualized and the treatment option selected to maximize success and the functional outcome of the child.

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Plagiocephaly

Positional plagiocephaly (or, "flat head" in infancy) is common due, in part, to the "back to sleep" campaign. The best treatment for this occurs when the infant is diagnosed early in life. In rare cases, the deformity is severe enough to warrant surgery. The pediatric neurosurgeons at Children’s Hospital of San Antonio can help guide the proper treatment for infants who harbor this deformity so that outcomes can be optimized.

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Spina Bifida

This is a congenital malformation of the spinal cord, which, at times, can involve the brain, as well. Management of patients with spina bifida often involves a multi-disciplinary approach. At Children’s Hospital of San Antonio, we have a regular clinic in which neurosurgery, orthopaedic surgery, rehab medicine, social workers, and urology are all involved to provide the most comprehensive care for patients with spina bifida.

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Surgical management of spasticity and dyston

Spasticity is commonly treated with medicaitons and/or injections. However, when those options do not work or have intolerable side effects, there are surgical procedures that can help. At Children’s Hospital of San Antonio, the neurosurgeons work closely with neurologists, orthopaedic surgery, and rehab medicine, to help select those patients who would benefit from surgery for spasticity. Surgeries include selective dorsal rhizotomy and placement of a baclofen pump.

Tethered Spinal Cord

A tethered spinal cord is a diagnosis that encompasses several different types of problems. Many of these are treated with surgery, although some can be monitored closely. In general, the surgery is designed to “release” the spinal cord from attachments that can tether it as the child grows, and cause problems with chronic pain, bladder dysfunction, scoliosis, weakness, and foot deformities.

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Helpful Links

The Hydrocephalus Association

Hydrocephalus Kids

Spina Bifida Association

Spina Bifida Texas

Conquer Chiari

American Syringomyelia & Chiari Alliance Project

Cranio Care Bears

Moyamoya.com