We provide state of the art diagnosis and treatment of pediatric neurological conditions.
Operating as usual
As we begin spring, it's important to know the similarities and differences between COVID-19 and seasonal allergies. If your child hasn't had allergies before or if their symptoms seem different, it's best to get your pediatrician's advice. Learn more from our experts at https://bit.ly/2Qk2QUv.
Photos from UT Southwestern Peter O'Donnell Jr. Brain Institute's post
5-year-old boy is seizure-free a year after advanced epilepsy surgery | Brain | Pediatrics | UT Southwestern Medical Center Born 16 weeks early, Jordan's health defied the odds. But at age 4, he started having back-to-back seizures – as many as 50 a day. See how team-based care and precision epilepsy surgery gave Jordan his life back, free from seizures.
Great article by one of our doctors, Dr. Angela Price.
#OnlineFirst: Retrospective analysis of open surgical versus laser interstitial thermal therapy callosotomy in pediatric patients with refractory epilepsy. https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2020.7.PEDS20167/article-10.3171-2020.7.PEDS20167.xml
nbcdfw.com Every week 15-year-old Sarah Stearns can be found on the soccer field amongst her Frisco Fusion teammates. Her love for the sport developed when she was just a toddler, but last year her ability to play soccer temporarily came to a halt.
twitter.com “The Journal of Neurosurgery @TheJNS is publishing an online series of editorials demonstrating the impact of #COVID19 on the practice of #Neurosurgery around the world. Learn more: https://t.co/8Q27YdWQrx”
To help protect the community we serve and limit the spread of novel coronavirus (COVID-19), we are rescheduling many non-emergency appointments and surgical procedures that are planned through April 9. We will contact you to reschedule appointments as needed. We appreciate your patience and support as we continue to create a safe care environment. For more information, please visit: https://bit.ly/2WusmqX
We are doing everything we can to keep our patients safe. Please read the following if you have an appointment with us.
As the number of cases of novel coronavirus (COVID-19) increase in North Texas, we will implement new visitor restrictions at all of our locations beginning Monday, March 16. This is in an effort to protect our patients, families, team members, and the community we serve during this time. We appreciate your understanding and support as we continue to create a safe care environment: http://bit.ly/2vnXsp8
Journal of Neurosurgery Publishing Group
#OnlineFirst: Health care transition in pediatric neurosurgery: a consensus statement from the American Society of Pediatric Neurosurgeon. Through surveys of ASPN neurosurgeons, current practice on HCT in pediatric neurosurgery is examined. https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2019.12.PEDS19524/article-10.3171-2019.12.PEDS19524.xml
cdc.gov The goal of the CDC Pediatric Mild Traumatic Brain Injury (mTBI) Guideline is to help healthcare providers take action to improve the health of their patients. The CDC Pediatric mTBI Guideline consists of 19 sets of clinical recommendations that cover diagnosis, prognosis, and management and treatme...
Our patient Jaydyn is an avid hockey and Dallas Stars fan. Since his brain surgery last month, Jaydyn has missed going to Stars games – the loud noises and bright lights are overwhelming for him right now. The Stars learned what a fan Jayden is and invited him to attend a private practice and tour the locker room. He met his favorite players and even had them sign his jersey. A special day Jaydyn will always remember! #KidsRule
dallasnews.com University of Texas Southwestern Medical Center was named the top hospital in Dallas-Fort Worth and the second best hospital in the state by the US...
Then and Now: Austin first met neurosurgeon Dr. Weprin at 10 years old when he came into our care with a rare condition. After a life-saving surgery, Dr. Weprin has continued to help Austin thrive throughout the years! #KidsRule
U. S. News and World Report recognizes Neurosurgery at Children’s Health. Congratulations to the neurosurgeons and all of the team members!
We are proud to once again be the only hospital in North Texas ranked in all 10 pediatric specialties by U.S. News and World Report . This recognition is a true testament to the quality care and dedication our team members, physicians, and leaders at Children's Medical Center Dallas show our patients and their families every day. Congrats to our #differencemakers! http://bit.ly/2IRhE5n
When our patients are ready to transition to adult care, Dr. Patel is one of the UTSW neurosurgeons waiting to take great care of them.
Doctors now have more options than ever for treating brain tumors such as gliomas. As both a researcher and neurosurgeon, Toral Patel, M.D., is uniquely qualified to offer state-of-the-art care for patients with both malignant and benign brain tumors.
utswmed.org After a stroke, concussion, or brain injury, the eyes provide clues about a patient’s brain health. In this week’s blog, Hunt Batjer, M.D., discusses how new technology helps doctors detect changes in brain functioning – and how coaches might soon be able to use pupillometry to detect concussi...
OUTCOMES from Sagittal Synostosis repair:
The goals of surgery are for the infant skull to gradually return to a more normal configuration when surgery is done early and followed by helmet therapy or for the immediate reshaping of the skull with the more extensive surgical procedures that are done later in infancy and in older toddlers. Endoscopic corrections done by experienced neurosurgeons rarely require transfusions and hospital stays are short. Cranial vault reconstruction surgeries which are usually done in the older infant or child frequently require blood transfusions and at least an overnight stay in an ICU setting with several days of post op hospitalization. Infections and airway difficulties occur with low frequency in both groups. Aside from these differences, there are potential later occurring complications from surgical correction of synostosis. However, overall complications rates for repair of isolated sagittal synostosis are low.
• Too rapid re-closure of the suture resulting in persistent deformity that may require second surgery
• Failure of the bone defect to fill back in with new bone resulting in a bony defect that may require future surgery
• Minor problems with skin breakdown attributed to helmet use
Overall the need for second surgery is low in non-syndromic patients.
Open surgery: As indicated, more extensive surgeries often are associated with longer hospital stays and need for transfusions. Additionally:
• Migration or loosening of the screws and plates used to reconstruct the skull can make them palpable and prominent so that surgical removal may be required
• It is intended that the reconstructed skull bones will heal, but nonunion of those bony plates can occur making additional surgery necessary.
• Delayed infection occurs infrequently and can require antibiotics and additional surgery.
This month's topic is CRANIOSYNOSTOSIS. We'll also talk about other causes for MISSHAPEN heads and how they are treated.
Anyone who has ever held a baby knows that their heads are different than an adult’s skull – they are softer and more pliable and have a soft spot on top which may vary in size. Unlike the adult skull which is a solid structure, the infant skull at birth is made up of separate bones that have not yet fused into a solid structure. The reason for this is that the infant’s brain is not fully developed at birth and has a lot of growing to do over the next few years. So, in order to allow for brain growth, the skull must be able to expand. It is able to do this because the bones are able to push apart as the brain inside is growing.
AT BIRTH, a baby’s head may be misshapen for several reasons:
• Constraint inside the mother’s uterus can compress an area of the skull causing some flattening;
• The process of being born vaginally can cause some shifting of the skull plates as the infant passes through the birth canal; and
• Pressure on the skull in the birth canal can cause fluid under the scalp (caput succedaneum) or bleeding under the skull lining (cephalohematoma) which distort the shape of the head.
These are not serious problems and will resolve on their own in the first few months of life.
• Because the skull is relatively soft, if the infant is continuously left in one position, the side resting against the surface (crib mattress, bassinet, etc.) will flatten. This problem has become especially more common with the “Back-to-Sleep” campaign that began in 1994 to decrease Sudden Infant Death Syndrome deaths. Infants placed on their backs with head turned to one side develop flat spots where the head has been resting, and sometimes develop an associated forehead asymmetry. This condition, POSITIONAL PLAGIOCEPHALY is a topic we will come back to in subsequent posts.
• A more serious problem occurs when the bones of the skull fuse prematurely. The space between the skull bones are called sutures. As noted above, skull growth occurs when the growth of the brain pushes the bones apart. If the sutures grow together prematurely (a condition called “SYNOSTOSIS”) before the brain has finished growing, the skull cannot expand in that area and leads to a misshapen head which will be permanent unless treated surgically.
We will discuss this further in future posts.
Tomorrow we will discuss basic skull anatomy.
Journal of Neurosurgery Publishing Group
#HistoricalVignette: Development of the Spitz—Holter valve in Philadelphia https://thejns.org/view/journals/j-neurosurg/95/1/article-p145.xml
Best in costume goes to Jolene as Dr. Weprin! We have a little fun here while also providing great care to our patients!
D Magazine features three of our pediatric neurosurgeons and several of our adult neurosurgeons.
utswmed.org D Magazine has named 13 members of the UT Southwestern Department of Neurological Surgery to its 2018 Best Doctors list. Learn how patients benefit from our outstanding care, and meet the neurosurgeons who make it possible.
Exciting things are happening at UT Southwestern!
dallasnews.com Ever since doctors diagnosed his son with a rare disease, Doug Woleben has spent every evening on his computer, searching for a way to save the...
Mayor Mike Rawlings
UT Southwestern Medical Center is one of the most important institutions of any kind in Dallas. We are grateful for the care they give to our community and all they are doing in science and medical research. Happy 75th birthday UT Southwestern Medical Center! #UTSW75
This story about one of our patients aired on Telemundo last week. It features an interview of Dr. Bruno Braga, one of our neurosurgeons. Not only is Dr. Braga a talented, compassionate surgeon, he speaks several languages. In addition to excellent English, Dr. Braga speaks Portuguese, Spanish, and Italian.
telemundodallas.com Juan Carlos de Luna fue el único sobreviviente entre los tres pequeños que se vieron involucrados en un accidente causado por un hombre que manejaba a exceso de velocidad. Por primera vez uno de los especialistas que atiende al pequeño habla de su caso.
UT Southwestern Neurology & Neurotherapeutics
Sunday, Oct. 29 is #WorldStrokeDay - a global advocacy campaign aimed at putting an end to stroke, the world’s second-leading cause of death and a primary source of preventable disability. #Didyouknow - the UTSW Stroke Team recently received the American Heart Association’s top honors: Gold Plus Quality Award and a spot on the Target Stroke Honor Roll Elite Plus. More about the awards: http://bit.ly/2zHllV5.
This is so cool! Dr. Darin Okuda and his team at UT Southwestern are using 3-D printing to make models of brain lesions in multiple sclerosis patients. The 3-D models could lead to more accurate diagnoses and treatments. You can read the study here: http://onlinelibrary.wiley.com/doi/10.1111/jon.12449/full
Dr. Bruno Braga was interviewed today by Carlos Zapata of Telemundo regarding one of our patients. We will post a link when it is available.
More about concussions, a hot topic this time of year, from one of our UTSW peers.
"I’ve heard parents say, 'Why would I want my child’s future sports agents to know how many concussions he’s had?'"
Currently, it's not mandatory for schools to report concussions—but Munro Cullum is leading a statewide project that aims to create a central registry of cases.
UT Southwestern Medical Center
Eleven years ago, Stacey Callaway didn’t know what was wrong. She had loss of vision in an area of one eye and thought a retina specialist could help. She never dreamed that she actually needed a brain surgeon.
“I remember thinking they were going to cut open my head…to pluck this thing out of my brain. Eleven years later and it’s still surreal,” said Stacey, who was then 34.
The retina specialist determined that Stacey’s loss of vision was not caused by problems with her eyes or optic nerve. In fact, a cyst was growing in her brain and it would require a craniotomy to remove it.
The McKinney-resident was referred to Bruce Mickey, M.D., in UT Southwestern's Neurology Department. Caetano Coimbra, M.D., was her surgeon.
Within two weeks, the surgery was scheduled. Stacey headed to Zale Lipshy University Hospital with her parents after completing her living will and DNR paperwork.
“I remember walking into that hospital and there, in the lobby, were my friends waiting for me. It was a big deal and I was scared to death, but I was still not admitting it. This was the day that a man would touch my brain and take "Ima" out of my head. Oh yes, we laughed about the cyst and gave her a name, we thought she’d be pickled when she came out. I had requests to keep her in a jar for posterity.”
Then it was time to prep for surgery. “They give me some happy juice and we start rolling down the hall. The walls were coming down around me. The smell of the hospital so starched and clean. The sounds seemed amplified, but not louder. I could hear the wheels on the bed squeaking as we rolled down the hall. I could hear the beeps of machines. I could almost hear the touch of my parents’ hands on me as we rolled down the hall. We stopped for one last kiss and a prayer before going on. Thank goodness for the happy juice, because I WAS SCARED.”
Stacey’s friends and family waited. And waited. At last the surgeon came out and told them the surgery was successful. Stacey would recover. Within hours she was awake and answering questions from neurology nurses to test her memory. Three days later, the mother of two went home.
“There’s a part of me that calls this my little “hiccup” even though I know it was a really big hiccup. I am a lucky person! I give all the credit to UTSW and would not want to be treated anywhere else,” said Stacey.
The experience prompted Stacey to further her studies for her teaching career. Not long after her surgery, she applied to a Ph.D. program in autism intervention at the University of North Texas, and graduated in 2014. Stacey has taught autistic children for 23 years.
See this report based on a study conducted at UTSW...
newsmax.com Numerous studies have shown how collision sports, such as football, affect the brains of players, but little research has been conducted to see if contact sports, such as soccer and basketball, also affect players' brains. Research at Canada's St. Michael's Hospital found...
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