Pediatric Neurosurgery

Pedi Neurosurgery Home

The Pediatric Neurosurgical Service, part of MassGeneral Hospital for Children in Boston, diagnoses and treats all neurosurgical conditions of infants, children and adolescents.

At MassGeneral Hospital for Children, MGHfC Logo patients have full access to all technologies available at Massachusetts General Hospital. This enables your child’s care team to utilize the best tools for your child's specific needs, including advanced imaging, intraoperative MRI, stereotactic image-guided surgery, ultrasound and laser equipment, and expert intraoperative functional monitoring of the brain and spinal cord. Our goal is to provide the best team with the best technology in order to perform surgery as safely as possible on each child.

The Pedi NS Service specializes in the surgical treatment of pediatric brain and spinal tumors in conjunction with a multidisciplinary team including pediatric neuroncologists and pediatric medical oncologists. Surgery of developmental anomalies presenting prenatally, in infancy, childhood, or adulthood including tethered spinal cord, spina bifida, syringomyelia (syrinx), myelomeningocele, hydrocephalus, normal pressure hydrocephalus, craniosynostosis, lipoma, dermal sinus, encephalocele, aqueductal stenosis, myeloschisis, lipomyelomeningocele, split cord malformation, diastematomyelia, Klippel-Feil syndrome, cerebrospinal fluid (CSF) shunts [including ventriculo-peritoneal (VP) and ventriculo atrial (VA) shunts], Dandy-Walker cyst, and Arnold-Chiari malformation are also a focus of this group of neurosurgeons.
Advanced surgical techniques for rare brain tumors, epilepsy or Chiari malformations. Urgent interventions for injuries due to trauma or stroke. Neurosurgery at Mass General Hospital for Children provides the best possible care to all pediatric patients with neurosurgical needs..
Our staff works closely with the departments of Anesthesia, Neurology, Physical Medicine and Rehabilitation, Plastic & Reconstructive Surgery, Hematology/Oncology & BMT and many others to promote positive outcomes for neurosurgical patients from birth to age 21, and to selected adults with congenital neurological disorders
Special Expertise

The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents. The team has special expertise in the management of:

  • Pediatric brain and spinal cord tumors
  • Vascular problems including arteriovenous malformations, aneurysms and moya-moya disease
  • Hydrocephalus and brain cysts
  • Craniosynostosis
  • Congenital anomalies of the spine and brain such as encephaloceles, Chiari malformations, syringomyelia, myelomeningocele, spinal lipomas and tethered spinal cord
  • Epilepsy surgery
  • Functional neurosurgery including spasticity and movement disorders
  • Neurosurgical trauma

Conditions Treated in Pediatric Neurosurgery
  • Acoustic Neuroma - Acoustic neurinoma, also referred to as acoustic neuroma or vestibular schwannoma, is a non-cancerous tumor that may develop from an overproduction of Schwann cells that press on the hearing and balance nerves in the inner ear.

    What is acoustic neuroma? - Acoustic neuroma, also referred to as vestibular schwannoma, is a noncancerous tumor that may develop from an overproduction of Schwann cells that press on the hearing and balance nerves in the inner ear. Schwann cells are cells that normally wrap around and support nerve fibers. If the tumor becomes large, it can press on the facial nerve or brain structure.

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    Cranial Base Center: A joint program of the Departments of Otolaryngology, Neurosurgery, and Radiation Oncology of MEEI and MGH, dedicated to the evaluation and treatment of patients with cranial base lesions.

  • Acute Spinal Cord Injury - Acute spinal cord injury (SCI) is a traumatic injury that either results in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord.

    What is an acute spinal cord injury? - Acute spinal cord injury (SCI) is due to a traumatic injury that either results in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord. SCI is a common cause of permanent disability and death in children and adults.

    ... read more ... or see the ...

    Neurosurgery Spine Service: The Neurosurgical Spine Service at Massachusetts General Hospital specializes in neurosurgical treatment of the entire spectrum of spine disorders, providing services from diagnosis through surgery and rehabilitation. Neurosurgical evaluation of neck and back pain, nerve compression syndromes, herniated intervertebral discs, and spinal cord compression syndromes. Information regarding peripheral nerve (including nerve compression such as carpal tunnel syndrome) and spine surgery.

  • Aneurysm - An aneurysm is a bulging, weakened area in the wall of a blood vessel resulting in an abnormal widening or ballooning greater than 50 percent of the normal diameter.

    What is an aneurysm? - An aneurysm is a bulging, weakened area in the wall of a blood vessel resulting in an abnormal widening or ballooning greater than 50 percent of the vessel's normal diameter (width). An aneurysm may occur in any blood vessel, but is most often seen in an artery rather than a vein.

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    Brain Aneurysm & AVM Center: The Endovascular and Open Vascular Neurosurgery Program at Massachusetts General Hospital specializes in Neuroendovascular problems of the brain and spinal cord, including brain aneurysms, arteriovenous malformations (AVMs) and carotid disease. For patients with aneurysms and arteriovenous malformations (AVMs) as well as other neurovascular problems of the brain and spinal cord.

  • Ataxia Telangiectasia (A-T) - Ataxia telangiectasia (A-T) is a rare inherited childhood disease that affects the nervous system and other body systems. The effects of A-T usually begin to appear by the age of 5 in a child affected by the disease.

    What causes A-T? - A-T is caused by mutations in a gene on chromosome 11 known as the ATM gene, which is involved in cell cycle control. This neurodegenerative disorder is inherited in an autosomal recessive fashion, which means that two mutated ATM genes are necessary to produce the condition--one inherited from each parent. People with only one ATM mutation are referred to as "carriers."

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    Pediatric Neurosurgery : The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Brain Tumors - A brain tumor is an abnormal growth of tissue in the brain. The tumor can either originate in the brain itself, or come from another part of the body and travel to the brain (metastasize). Brain tumors may be classified as either benign (non-cancerous) or malignant (cancerous), depending on their behavior.

    What is a brain tumor? - A benign tumor does not contain cancer cells and usually, once removed, does not recur. Most benign brain tumors have clear borders, meaning they do not invade surrounding tissue. These tumors can, however, cause symptoms similar to cancerous tumors because of their size and location in the brain.

    Malignant brain tumors contain cancer cells. Malignant brain tumors are usually fast growing and invade surrounding tissue. Malignant brain tumors very rarely spread to other areas of the body, but may recur after treatment. Sometimes, brain tumors that are not cancer are called malignant because of their size and location, and the damage they can do to vital functions of the brain.

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    MGH Brain Tumor Center : The Stephen E. and Catherine Pappas Center for Neuro-Oncology at Massachusetts General Hospital offers the most advanced care for patients with brain tumors and nervous system tumors.

    A coordinated, multidisciplinary approach to the care of adult and pediatric patients with tumors of the nervous system as well as neurologic complications of cancer.

    Malignant Tumors: Information regarding malignant tumors of the brain, spine, and peripheral nerves. Benign Tumors: Information about benign brain tumors including meningioma, epidermoid, dermoid, hemangioblastoma, colloid cyst, subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma, and craniopharyngioma.

  • Chiari Malformation - A Chiari malformation is a congenital (present at birth) defect in the area of the back of the head where the brain and spinal cord connect.

    What is a Chiari malformation? - The condition is also called Arnold Chiari malformation. There are four types of Chiari malformations, including the following:

    • Type I. Commonly goes unnoticed until problems arise in the adolescent or adult years of life. In this condition, the base of the skull and the upper spinal area are not formed properly.
    • Type II. This is the most common type of Chiari malformation. In this condition, part of the back of the brain shifts downward through the bottom of the skull area.
    • Type II Chiari malformations are typically seen in infants who are born with spina bifida, a neurological condition that causes a portion of the spinal cord and the surrounding structures to develop outside, instead of inside, the body.
    • Type II Chiari malformations can also be associated with a condition known as hydrocephalus. Hydrocephalus is a condition in which there is an overproduction or lack of absorption of the cerebral spinal fluid (CSF) that is found inside of the ventricles (fluid-filled areas) inside of the brain. The increased fluid causes the pressure inside of the head to increase and the skull bones to expand to a larger-than-normal appearance.
    • Type III. The back of the brain protrudes out of an opening in the back of the skull area.
    • Type IV. The back of the brain fails to develop normally.

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    Brain Aneurysm & AVM Center: The Endovascular and Open Vascular Neurosurgery Program at Massachusetts General Hospital specializes in Neuroendovascular problems of the brain and spinal cord, including brain aneurysms, arteriovenous malformations (AVMs) and carotid disease. For patients with aneurysms and arteriovenous malformations (AVMs) as well as other neurovascular problems of the brain and spinal cord.

  • Cowden Syndrome - The risk for breast cancer, endometrial (uterine) cancer, gastrointestinal cancers, and thyroid cancer is increased with Cowden syndrome, a rare inherited disorder that is also associated with a number of specific noncancerous features.

    What is Cowden Syndrome? - Cowden syndrome is caused by mutations in a gene on chromosome 10 known as PTEN. About 85 percent of people whose symptoms meet the criteria for a diagnosis of Cowden syndrome will have a PTEN mutation. Mutations in PTEN confer a 25 to 50 percent lifetime risk for breast cancer, about a 10 percent risk of thyroid cancer, and potentially up to a 5 to 10 percent risk of endometrial cancer. Cowden syndrome is associated with the following characteristics:

    • Multiple benign, or noncancerous, tumors of normal organ tissue of the skin and other organs, usually present by the late 20s
    • Macrocephaly (increased head size)
    • Noncancerous breast and thyroid diseases are common
    • Mental retardation
    • A rare, noncancerous brain tumor called Lhermitte-Duclos disease
    • Additional features can include noncancerous thyroid lesions, intestinal polyps, lipomas (benign fatty tumors), fibromas, uterine fibroids, and fibrocystic disease of the breast.

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    Pediatric Neurosurgery Service: The Pediatric Neurosurgery Service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Craniosynostosis (Craniofacial Anomaly) - Craniosynostosis is a condition in which sutures close too early, causing problems with normal brain and skull growth. Premature closure of the sutures may also cause the pressure inside of the head to increase and the skull or facial bones to change from a normal, symmetrical appearance.

    What causes craniosynostosis? - Craniosynostosis occurs in one out of 2,200 live births and affects males slightly more often than females. Craniosynostosis is most often sporadic (occurs by chance). In some families, craniosynostosis is inherited in one of two ways:

    • Autosomal recessive - Autosomal recessive means that two copies of the gene are necessary to express the condition, one inherited from each parent, who are obligate carriers. Carrier parents have a one in four, or 25 percent, chance with each pregnancy, to have a child with craniosynostosis. Males and females are equally affected.
    • Autosomal dominant - Autosomal dominant means that one gene is necessary to express the condition, and the gene is passed from parent to child with a 50/50 risk for each pregnancy. Males and females are equally affected.

    Craniosynostosis is a feature of many different genetic syndromes that have a variety of inheritance patterns and chances for future children, depending on the specific syndrome present. It is important for the child as well as family members to be examined carefully for signs of a syndromic cause (inherited genetic disorder) of craniosynostosis such as limb defects, ear abnormalities, or cardiovascular malformations.

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    Pediatric Neurosurgery : The Pediatric Neurosurgery Service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Epilepsy and Seizures - Epilepsy is a neurological condition involving the brain that makes people more susceptible to having seizures.

    What is epilepsy? - Epilepsy is a neurological condition involving the brain that makes people more susceptible to having recurrent, unprovoked seizures. It is one of the most common disorders of the nervous system and affects people of all ages, races, and ethnic background. Almost 3 million Americans live with epilepsy.

    What is a seizure? - The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that communicate with each other through electrical activity. A seizure occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

    A seizure occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

    Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure. This includes a high fever, low blood sugar, high blood sugar, alcohol or drug withdrawal, or a brain concussion. Under these circumstances, anyone can have one or more seizures. However, when a person has two or more unprovoked seizures, he or she is considered to have epilepsy. There are many possible causes of epilepsy, including an imbalance of nerve-signaling chemicals called neurotransmitters, tumors, strokes, and brain damage from illness or injury, or some combination of these. In the majority of cases, there may be no detectable cause for epilepsy.

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    Functional and Stereotactic Neurosurgery Center: - The Functional Neurosurgery Center at Massachusetts General Hospital provides expert evaluations and surgical treatment for patients with movement disorders, epilepsy and psychiatric conditions such as obsessive-compulsive disorder and chronic pain. Functional and Stereotactic Neurosurgery Center: Including electrophysiologically monitored pallidotomy for medically refractory Parkinson's disease, obsessive compulsive disorder, cancer-related- and chronic-pain syndromes, thalamotomy for disabling tremor and epilepsy surgery for the surgical treatment of medically refractory seizures.

    • Movement Disorders
    • Parkinson's Disease
    • Epilepsy Surgery
    • TN & HFS
  • Head Injury - A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head.

    What is a head injury? - Head injuries are one of the most common causes of disability and death in adults. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain.

    A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma.

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    Pediatric Neurosurgery : The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

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    Trauma, Emergency, Intensive Care, and General Neurosurgery Center: The Spinal Cord and Head Trauma Center, and the NeuroScience Care Units diagnoses and treats patients with severe spinal cord and brain disorders resulting from trauma. Information on Physical Therapy for Brain Injury.

    Massachusetts General Hospital is a Level 1 Adult and Level 1 Pediatric Trauma Center. MGH has been verified as able to treat the highest severity of trauma patient. MGH admits, on average, 2,000 trauma patients and another 2,000 emergency surgery patients per year, and although the vast majority of our patients are from the Boston metropolitan area, patients are referred to our facility from all over the country.

  • Hydrocephalus - Hydrocephalus is a condition in which there is excessive fluid in and around the brain. It occurs from a lack of absorption, blockage of flow, or overproduction of the cerebral spinal fluid (CSF) that's made inside the ventricles (fluid-filled areas) of the brain and disperses from the ventricles around the brain and spinal cord. This may result in a buildup of fluid that can cause the pressure inside of the head to increase. In a child, this causes the bones of the skull to expand and separate to a larger-than-normal appearance.

    What causes hydrocephalus? - Hydrocephalus occurs in approximately one out of 500 births. The following are the primary reasons why hydrocephalus occurs:

    • Blockage of the CSF flow inside of the head
    • Problems absorbing CSF
    • Overproduction of CSF (rare)

    Hydrocephalus can occur either as a condition present at birth (congenital), or it can be acquired later in life. When hydrocephalus is not related to a known genetic cause, it's thought that many factors, both genetic and environmental, contribute to the condition. In a small percentage of babies, a single gene defect on the X chromosome, or another chromosome, is responsible for the condition. If a child has been born with hydrocephalus not known to be caused by a single gene defect, the chance of it occurring in another child is 1 to 5 percent.

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    Pediatric Neurosurgery Service: The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Landau-Kleffner Syndrome - Landau-Kleffner syndrome (also called infantile acquired aphasia, acquired epileptic aphasia or aphasia with convulsive disorder) is a language disorder characterized by the gradual or sudden loss of the ability to use or comprehend spoken language.

    What is Landau-Kleffner syndrome? - Landau-Kleffner syndrome is a rare language disorder. It frequently occurs in normally developing children, usually between five and seven years of age, and is characterized by the gradual or sudden loss of the ability to use or comprehend spoken language.

    The following are the most common indicators of Landau-Kleffner syndrome. However, each individual may experience symptoms differently.

    • Early signs may be referred to as auditory agnosia, which includes the child:
      • Suddenly having problems understanding what is said
      • Appearing to have problems with hearing and deafness may be suspected
      • Appearing to be autistic or developmentally delayed
    • Spoken language is eventually affected, which may lead to complete loss of the ability to speak.
    • Seizure disorder
    • Some children develop their own method of communicating, such as using gestures or signs.

    Hearing and intelligence usually are confirmed to be normal in children with Landau-Kleffner syndrome

    The symptoms of Landau-Kleffner syndrome may resemble other conditions or medical problems, such as deafness or learning disabilities. Always consult your health care provider for a diagnosis.

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    Pediatric Neurosurgery Service: The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Lumbar Disc Disease (Herniated Disc) - Lumbar disc disease occurs in the lumbar area of the spine. As discs degenerate, fragments of the disc material can press on the nerve roots located just behind the disc space, causing pain, numbness or changes in sensation.

    Anatomy of the lumbar spine - The vertebral column, also called the backbone, is made up of 33 vertebrae that are separated by spongy disks and classified into four distinct areas. The cervical area consists of seven bony parts in the neck; the thoracic spine consists of 12 bony parts in the back area; the lumbar spine consists of five bony segments in the lower back area; five sacral bones (fused into one bone, the sacrum); and four coccygeal bones (fused into one bone, the coccyx).

    Lumbar disk disease occurs in the lumbar area of the spine. The lumbar area of the spine (and other areas of the spine) is made up of two parts, including the following:

    • Vertebral bodies. The parts that are made of bone.
    • Intervertebral disks (also known as the disks). The disks are located between the bony parts of the spine and act as "shock absorbers" for the spine.

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    Neurosurgery Spine Service: The Neurosurgical Spine Service at Massachusetts General Hospital specializes in neurosurgical treatment of the entire spectrum of spine disorders, providing services from diagnosis through surgery and rehabilitation. Neurosurgical evaluation of neck and back pain, nerve compression syndromes, herniated intervertebral discs, and spinal cord compression syndromes.

    • Neurosurgical Service's Spine Evaluation Unit
    • Disc & Spinal Cord Compression
    • Spine & Spinal Cord Tumor
    • Brian D. Silber Spine Tumor Clinic
  • Neurocutaneous Syndromes - Neurocutaneous syndrome is a broad term for a group of neurologic disorders that can cause tumors to grow inside the brain, spinal cord, organs, skin and skeletal bones.

    What are neurocutaneous syndromes? - Neurocutaneous syndrome is a broad term for a group of neurologic (brain, spine, and peripheral nerve) disorders. These diseases are lifelong conditions that can cause tumors to grow inside the brain, spinal cord, organs, skin, and skeletal bones.

    The three most common types of neurocutaneous syndromes are:

    • Tuberous sclerosis (TS)
    • Neurofibromatosis (NF): Type I, Type II, and schwannomatosis
    • Sturge-Weber disease

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    Pediatric Neurosurgery Service: The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Neurogenic Bladder - The following problems are often associated with a neurogenic bladder: urine leakage, urine retention, damage to the tiny blood vessels in the kidney, and infection of the bladder or ureters.

    What is a neurogenic bladder? - The muscles and nerves of the urinary system work together to hold urine in the bladder and then release it at the appropriate time. Nerves carry messages from the bladder to the spinal cord and brain and from the collections of nerves in the peripheral nervous system to the muscles of the bladder telling them either to tighten or release. In a neurogenic bladder, the nerves that are supposed to carry these messages do not work properly.

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    Pediatric Neurosurgery Service: The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.

  • Seizures - Epilepsy is a neurological condition involving the brain that makes people more susceptible to having seizures.

    What is a seizure? - The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that communicate with each other through electrical activity. A seizure occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

    ... read more ... or see the ...

    Functional and Stereotactic Neurosurgery Center: - The Functional Neurosurgery Center at Massachusetts General Hospital provides expert evaluations and surgical treatment for patients with movement disorders, epilepsy and psychiatric conditions such as obsessive-compulsive disorder and chronic pain. Functional and Stereotactic Neurosurgery Center: Including electrophysiologically monitored pallidotomy for medically refractory Parkinson's disease, obsessive compulsive disorder, cancer-related- and chronic-pain syndromes, thalamotomy for disabling tremor and epilepsy surgery for the surgical treatment of medically refractory seizures.

    • Movement Disorders
    • Parkinson's Disease
    • Epilepsy Surgery
    • TN & HFS
  • Spinal Cord Injury - Acute spinal cord injury (SCI) is due to a traumatic injury that can either result in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord.

    What is an acute spinal cord injury? - The spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body.

    Acute spinal cord injury (SCI) is due to a traumatic injury that can either result in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord. SCI is more common in men and young adults.

    There are about 12,000 new cases of SCI each year. The number of people in the U.S. in 2008 living with a spinal cord injury was approximately 259,000.

    SCI results in a decreased or absence of movement, sensation, and body organ function below the level of the injury. The most common sites of injury are the cervical and thoracic areas. SCI is a common cause of permanent disability and death in children and adults.

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    Neurosurgery Spine Service: The Neurosurgical Spine Service at Massachusetts General Hospital specializes in neurosurgical treatment of the entire spectrum of spine disorders, providing services from diagnosis through surgery and rehabilitation. Neurosurgical evaluation of neck and back pain, nerve compression syndromes, herniated intervertebral discs, and spinal cord compression syndromes.

    • Neurosurgical Service's Spine Evaluation Unit
    • Disc & Spinal Cord Compression
    • Spine & Spinal Cord Tumor
    • Brian D. Silber Spine Tumor Clinic
  • Tourette's Disorder - Tourette's disorder (TD), sometimes called Tourette's syndrome (TS), is a neurological disorder characterized by multiple repeated tics.

    What is Tourette's disorder (TD)? - Tourette's disorder (TD), sometimes called Tourette's syndrome (TS), is a neurological disorder characterized by multiple repeated tics. Tics are abrupt, purposeless, and involuntary vocal sounds or muscular jerks. Symptoms of TD usually begin between the ages of five and 10 years of age, and usually begin with mild, simple tics involving the face, head, or arms. With time, tics become more frequent and increase in variety, involving more body parts such as the trunk or legs, and often become more disruptive to activities of daily living (ADLs).

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    Pediatric Neurosurgery Service: The Pediatric Neurosurgery service at MassGeneral Hospital for Children diagnoses and treats all neurosurgical conditions of infants, children and adolescents, with special expertise in the management of pediatric brain tumors, hydrocephalus, spinal cord disorders, Chiari malformations, craniosynostosis, AVM's and epilepsy surgery.


When your child needs a hospital, everything matters.

Children and adolescents with brain, spine and nervous system disorders need the best medical care. The Neurosciences Center at Mass General Hospital for Children offers patients and families a comprehensive approach from initial diagnosis and treatment to rehabilitation and long-term follow-up care. Our program is designed to offer patients a disease-specific, patient-focused approach.


Looking for a specific service or condition?
MGHfC NeuroScience

The Neurosciences Center at Mass General Hospital for Children offers treatment and services for a wide range of neurological conditions that can stem from genetic abnormalities or immune system deficiencies or from injury to the brain or nervous system. Learn more about our Neurosciences Service or about Neurosciences conditions.

The Neuroscience Center at MassGeneral Hospital for Children brings together physicians with the expertise to develop and apply the most effective approaches to help children with neurological disorders.
Specialists from Neurology, Neurosurgery, Pediatric Intensive Care, Pediatric Oncology, Psychiatry, Neurogenetics and Rehabilitation coordinate their efforts through the Neuroscience Center. An experienced team of nurses, psychologists and physical, occupational, and speech therapists at the center provide the best possible care to patients and families.

Family-Centered, Collaborative Care

Your pediatric neurosurgery team works with you and your child, and with many other specialists at MGHfC, to ensure that your child has everything he or she needs. We work closely with all pediatric specialists:

  • Child neurology
  • Pediatric neuroradiology
  • Neuropsychology
  • Pediatric critical care medicine
  • Pediatric emergency medicine
  • Pediatric anesthesia
  • Pediatric imaging
  • Child psychiatry
  • Ethics
  • Child development
  • Social work
  • Pediatric nursing
  • Child behavior
  • Pediatric rehabilitation and other therapies (Physical, Occupational, Speech and language
  • A full range of pediatric medical and surgical subspecialties

The Best Care for Your Patients is Our Goal

Our staff members are dedicated to helping you provide routine and emergency care for your patients, whether the care involves consultations, treatment or follow-tip.

This team meets initially to explore all treatment options and then presents their recommendations to the parents and, when appropriate, the child. Every specialist describes the steps that his or her therapy involves. Once the course of action is agreed upon, the team continues to meet and make adjustments in treatment as warranted. The goal is to provide comprehensive care and effective outcomes.

You will be continually briefed about the progress of your patients. And through our Nurse Coordinator, who serves as a liaison between you and your patient and us, you can count on someone always being available to take calls, answer questions and facilitate the care of all inpatients and outpatients.


Translating Advances in Adult Care to Help Children
Proton beam therapy:
Our patients have access to proton beam therapy through the Francis H. Burr Proton Therapy Center, which directs radiation to the diseased tissue only and protects surrounding areas. Special protocols for young children ensure that they can receive this radiation treatment more safely, which is critical when long-term effects on growth and development must be considered very carefully.
Epilepsy surgery:
Research and technologic advances in localizing where seizures arise in the brain using advanced, non-invasive imaging, magnetoencephalography, and other techniques help children and families determine whether surgery might be helpful in managing epilepsy. Several research projects are ongoing as well using microelectrodes and other types of brain recording to advance the understanding and treatment of epilepsy in children for whom routine treatments haven’t fully controlled seizures.
Deep brain stimulation (DBS):
Used for the treatment of Parkinson’s disease and other movement disorders in adults, DBS represents another area where interdisciplinary collaboration can lead to safe and effective translation of adult treatments into improved pediatric care. DBS works by providing a tiny focused amount of electrical stimulation to a specific part of the brain to allow malfunctioning brain circuits to work more normally. Children and adolescents with specific types of movement disorders and behavioral problems can be evaluated for treatment with these innovative approaches.
Brain tumor screening:
We have established a laboratory in which tumor specimens are genotyped, or evaluated for their genetic composition, to find specific types that are known to respond to existing drugs or that represent new targets for drug development. Routine screening for many cancers, including brain tumors, is already in place for adult patients. Genotyping in pediatric brain tumors could lead to similar advances in the treatment of children.
Stereotactic radiosurgery:
Mass General pioneered stereotactic radiosurgery for use in treating brain tumors and vascular malformations in children and adults. This focused radiation technique substantially decreases the amount of radiation to normal tissue in specific types of brain tumors or blood vessel abnormalities. Experts at Mass General have extensive experience using these approaches for children.

The Department of Neurosurgery has surgeons who specialize in all phases of neurological surgery for comprehensive management of brain, spinal cord, and peripheral nerve diseases and disorders. The subspecialties of the neurosurgical department include:

  • AneurysmAVMBrain Aneurysm & AVM Center - The Endovascular and Open Vascular Neurosurgery Program at Massachusetts General Hospital specializes in Neuroendovascular problems of the brain and spinal cord, including brain aneurysms, arteriovenous malformations (AVMs) and carotid disease.
    For patients with aneurysms and arteriovenous malformations (AVMs) as well as other neurovascular problems of the brain and spinal cord. Including the Neurovascular News; - A newsletter with information regarding carotid endarterectomy to prevent stroke, transient ischemic attack or TIA; brain aneurysms; arteriovenous malformations and other vascular lesions affecting the brain and spinal cord with information on the MGH Brain AVM and Aneurysm Center. Information on the MGH Interventional Neuroradiology Center.
    ...read more...
  • BrainTumorMGH Brain Tumor Center - The Stephen E. and Catherine Pappas Center for Neuro-Oncology at Massachusetts General Hospital offers the most advanced care for patients with brain tumors and nervous system tumors.
    A coordinated, multidisciplinary approach to the care of adult and pediatric patients with tumors of the nervous system as well as neurologic complications of cancer.
    Malignant Tumors: Information regarding malignant tumors of the brain, spine, and peripheral nerves. Benign Tumors: Information about benign brain tumors including meningioma, epidermoid, dermoid, hemangioblastoma, colloid cyst, subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma, and craniopharyngioma.
    ...read more...
  • CranialBaseCenterMGH / MEEI Cranial Base Center - Run jointly by Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary (MEEI), the Cranial Base Center treats tumors and other cranial nerve disorders.
    A joint program of the Departments of Otolaryngology, Neurosurgery, and Radiation Oncology dedicated to the evaluation and treatment of patients with cranial base lesions.
    A Multidisciplinary Approach to Rare, Complex Tumors - Because of their location close to a dense concentration of critical structures (the cranial nerves, spinal cord, and major blood vessels to and from the brain), neoplasms of the cranial base — the bony interface separating the brain from the structures outside the cranium — are among the most complex and challenging conditions to treat. Whether benign or malignant, cranial base tumors may be equally problematic; depending on their location, they can affect vision, hearing, olfaction, speech, swallowing, movement, or cognition.
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  • PituitaryTumorPituitary Tumor & Neuroendocrine Clinical Center - The Neuroendocrine Surgical Service at Massachusetts General Hospital evaluates, treats and manages care for patients with pituitary and hypothalamic tumors and other complex disorders. Treatment for adenomas sometimes includes transsphenoidal surgery.
    A multidisciplinary approach to patients with pituitary and hypothalamic disorders. Including the Neuroendocrine Center Bulletin - A newsletter with information regarding pituitary tumors. Information on acromegaly, Cushing's disease or syndrome, prolactinoma, chromophobe or nonfunctioning pituitary adenoma, and thyrotroph adenomas.
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  • NeuroSpineNeurosurgery Spine Service - The Neurosurgical Spine Service at Massachusetts General Hospital specializes in neurosurgical treatment of the entire spectrum of spine disorders, providing services from diagnosis through surgery and rehabilitation.
    Neurosurgical evaluation of neck and back pain, nerve compression syndromes, herniated intervertebral discs, and spinal cord compression syndromes. Information regarding peripheral nerve (including nerve compression such as carpal tunnel syndrome) and spine surgery.
    - Neurosurgical Service's Spine Evaluation Unit
    - Disc & Spinal Cord Compression
    - Spine & Spinal Cord Tumor
    - Brian D. Silber Spine Tumor Clinic
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  • PediatricNeurosurgeryPediatric & Developmental Neurosurgery - The Pediatric Neurosurgical Service, part of MassGeneral Hospital for Children in Boston, diagnoses and treats all neurosurgical conditions of infants, children and adolescents.
    A multidisciplinary team including pediatric neuroncologists and pediatric medical oncologists for the surgical treatment of pediatric brain and spinal tumors. Surgery of developmental anomalies presenting prenatally, in infancy, childhood, or adulthood including tethered spinal cord, spina bifida, syringomyelia, myelomeningocele, hydrocephalus, craniosynostosis, lipoma, dermal sinus, encephalocele, aqueductal stenosis, myeloschisis, lipomyelomeningocele, split cord malformation, diastematomyelia, Klippel-Feil syndrome, CSF shunts, Dandy-Walker cyst, and Arnold-Chiari malformation.
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  • InterventionalNeuroRadiologyMGH Interventional Neuroradiology Center - A minimally invasive approach in the treatment of vascular diseases of the central nervous system. Conditions in the past that would have required surgical intervention such as aneurysms, vascular malformations, and tumors of the brain, spine, head and neck can be considered for treatment by using an endovascular approach to reach the lesion.
    The Purpose of this Center is to provide a complete range of services for the diagnosis, treatment and rehabilitation of patients with neurovascular problems of the brain and spinal cord. Patients may be referred for consultation only, care in partnership with referring physician, or complete management
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  • NeuroImagingNeuro Imaging Resources - Three-dimensional, 2D and functional imaging to visualize cerebral anatomy to enable neurosurgeons to plan procedures to spare crucial cortical areas, improve patient care and reduce operating room time.
    Three-dimensional visualization of cerebral vasculature from CT angiography provides increased confidence in planning surgical intervention in life-threatening aneurysm cases. 3D views of MRI cortical surface and underlying tissues, with optional functional MRI fused with 3D anatomical display, enables neurosurgeons to plan procedures to spare crucial cortical areas, improve patient care and reduce operating room time.
    The MGH Radiology department with specialized units for Neuroradiology, Interventional Neuroradiology and Radiology 3-D Imaging work as multidisciplinary teams with a focus on neurological conditions.
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  • ProtonBeamRadiosurgeryProton Stereotactic Radiosurgery (Neurosurgery) Center - The Proton Beam Unit was founded in 1962 and has the largest experience with stereotactic radiosurgery of any center in the United States. Information regarding non-invasive proton beam radiosurgery and fractionated radiosurgery for brain and spinal tumors and arteriovenous malformations.
    The Proton Stereotactic Radiosurgery Center provides a complete range of services for the diagnosis and non-invasive proton beam radiosurgery and fractionated radiosurgery treatment for brain and spinal tumors and other vascular malformations.
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  • PeripheralNervePeripheral Nerve Service - The Peripheral Nerve Surgery Service at Massachusetts General Hospital treats peripheral nerve injuries, tumors and other disorders affecting the network of nerves that link the brain and spinal cord to other parts of the body.
    Advanced Treatment of Peripheral Nerve Issues. One of the only centers in the northeastern United States specializing in surgical treatment of peripheral nervous system disorders, the Peripheral Nerve Surgery Service at Massachusetts General Hospital offers advanced treatment options to restore sensation, movement and motor skills.
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  • FunctionalNeurosurgeryFunctional and Stereotactic Neurosurgery Center - The Functional Neurosurgery Center at Massachusetts General Hospital provides expert evaluations and surgical treatment for patients with movement disorders, epilepsy and psychiatric conditions such as obsessive-compulsive disorder and chronic pain.
    Functional and Stereotactic Neurosurgery Center: Including electrophysiologically monitored pallidotomy for medically refractory Parkinson's disease, obsessive compulsive disorder, cancer-related- and chronic-pain syndromes, thalamotomy for disabling tremor and epilepsy surgery for the surgical treatment of medically refractory seizures.
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  • NeurogeneticSurgeryNeurogenetic Surgery Center - Surgical and non-surgical multidisciplinary management of inherited neurologic syndromes including neurofibromatosis type I (Von Recklinghausen's disease) and II, tuberous sclerosis, and Von Hippel-Lindau disease.
    The Center offers a comprehensive initial evaluation to all persons in whom a diagnosis of neurogenetic associated diseases has been suggested or confirmed. In addition to a neurological examination this includes a dermatological evaluation and referral for neuro-ophthalmological evaluation and imaging studies.
    - Neurogenetics Clinic
    - Neurofibromatosis Clinic
    - Von Hippel-Lindau Clinic
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  • NeuroScienceCareNeurosciences Intensive Care Unit - Neurosciences Intensive Care Unit (Neuro ICU) patients receive intensive medical and nursing management for post-surgical and post-interventional conditions, as well as stroke, cerebral hemorrhage, seizure, and head and spinal cord injuries.
    Information on the Neurological Intensive Care Unit (NICU) which provides comprehensive care for seriously ill neurological and neurosurgical patients and Inpatient Information from the Neuroscience Care Units Guest Information System which encompass the Neuroscience, Neurology and Neurosurgery clinical system.
    The MGH Neurointensive Care Unit is a state-of-the-art 18 bed ICU supported by 6-8 full time dedicated Neuro ICU fellows, 8 intensivist faculty, 24 hour video-EEG, portable CT capability, 64-slice helical CT and 1.5-3.0 T MRI with 3D imaging available at all times.
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  • NeuroORNeurosurgery Operating Rooms - Innovative use of technologies to assist surgeons in complex neurological procedures. Information on new intra-operative MRI Imaging, and CT Imaging systems. Use of Stereotactic Neurosurgery for Surgical Case Planning and Optical Tracking Systems (OTS) to define optimal surgical approach.
    Intra-operative mapping by direct cortical stimulation - electrophysiological recordings systems - to map functional anatomy during surgery
    The Neurosurgery ORs features intra-operative imaging, the latest technology in brain tumor removal surgery. Intra-operative MRI and CT scanners provide real-time information, allowing surgeons to monitor a patient’s brain and measure tumor removal at any point during the procedure without moving the patient.
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  • TraumaCriticalCareTrauma, Emergency, Intensive Care, and General Neurosurgery Center - The Spinal Cord and Head Trauma Center, and the NeuroScience Care Units diagnoses and treats patients with severe spinal cord and brain disorders resulting from trauma. Information on Physical Therapy for Brain Injury.
    Massachusetts General Hospital is a Level 1 Adult and Level 1 Pediatric Trauma Center. MGH has been verified as able to treat the highest severity of trauma patient. MGH admits, on average, 2,000 trauma patients and another 2,000 emergency surgery patients per year, and although the vast majority of our patients are from the Boston metropolitan area, patients are referred to our facility from all over the country.
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Other neurosurgical intervention across the spectrum of neuroscience care.

Referrals

MassGeneral Hospital for Children is committed to making expert, state-of-the-art treatment available to children from across the community and beyond. The members of our network, which includes Newton-Wellesley and North Shore Children’s Hospitals, as well as hundreds of community pediatricians and pediatric specialists, work together to ensure that this goal is met.

Either families or physicians may make referrals to or inquiries about our Pediatric Neurosurgical Services by calling 617-726 3887.

Massachusetts General Hospital is consistently ranked among the top three hospitals in the country and its pediatric services in the top 1% in the nation by U.S. News & World Report Annual Guide to America’s Best Hospitals.We were the first hospital in the nation to attain Level 1 verification in Adult Trauma, Pediatric Trauma and Adult Burn. Our Brain Tumor Center receives referrals from medical centers around the world to care for children whose care is most challenging.



MGH Pediatric Neurosurgical Servicer - Wang Ambulatory Care Center - ACC-331 - Neurosurgical Service - Phone: 617-643-9175 - Fax: 617-726-7546 - Massachusetts General Hospital - 15 Parkman Street - Boston, Massachusetts 02114