Neurosurgery

Members of the Section of Pediatric Neurosurgery deal with a wide variety of congenital and acquired lesions of the brain, spinal cord and peripheral nerves. Approximately 5,500 children are seen in the pediatric neuroscience outpatient clinic, resulting in over 300 operative cases per year.

Neurosurgical residents usually spend two, three-month rotations as junior residents on the pediatric neurosurgery service. During this time, they are encouraged to undertake a clinical research project for presentation at a national meeting.

Each chief resident spends six months running the pediatric neurosurgery service and performing routine and complex operations. By the end of the year, the chief resident will have managed most pediatric neurosurgical disorders, and is encouraged to participate in the annual meeting of the Pediatric Section of the American Association of Neurological Surgeons.

The following subspecialty programs comprise the Cleveland Clinic’s Section of Pediatric Neurosurgery:

Pediatric Brain Tumors
Residents gain extensive intraoperative exposure to microsurgical techniques and computer-assisted stereotactic neurosurgery.
Cleveland Clinic neurosurgeons operate on approximately 60 patients with pediatric brain and spinal tumors per year. Cases are
discussed at a weekly brain tumor conference.

Birth Defects
The Cleveland Clinic Children’s Hospital’s birth defect program follows children with a wide range of congenital brain, craniofacial
and spinal anomalies, including spina bifida and myelomeningocele, hydrocephalus, tethered cord syndrome and other forms of
occult spinal dysraphism.

A multidisciplinary surgical team performs complete craniofacial reconstructions for craniosynostosis and other anomalies.

Cerebral Palsy
In this program, a pediatric neurosurgeon, a pediatric orthopaedic surgeon and physical therapists evaluate children with
cerebral palsy to determine their optimal management. Cleveland Clinic neurosurgeons have an active program in selective
dorsal rhizotomy, a microsurgical procedure that reduces spasticity in some children. Other children with the disease may benefit
from an implanted device for CSF drug delivery.

Epilepsy Surgery
The surgical procedures offered include a variety of electrode placements for monitoring and brain mapping; temporal lobectomy;
extra-temporal focal resection; brain tumor resection using functional mapping; corpus callosotomy and hemispherectomy for
hemimegalencephaly.

Residents will learn the work-up required to localize epileptic foci, as well as techniques for exposure and removal of epileptic
brain tissue.

Hydrocephalus
Advanced treatments in hydrocephalus are being developed and used at The Cleveland Clinic. The neuroendoscope is used in
placing shunts, locating hydrocephalus and performing ventriculostomies. Computer-assisted neuroendoscopic procedures are being developed here for complex cases.

Basic research in the pathophysiology of hydrocephalus gives the resident a balanced and thorough exposure to hydrocephalus and its treatments. Clinical research programs in hydrocephalus give exposure to treatments in hydrocephalus.

Staff
Mark Luciano, M.D.
William E. Bingaman, M.D.