Pediatric Neurosurgery Story Book:

(Acrobat pdf version)

Pediatric & Developmental Neurosurgery Center:

clinical
profiles

“When it came time to tell Jake that he was going to have surgery, I just didn’t feel that I had the strength and courage to do it. I knew I would cry and that would make Jake feel afraid. I was so grateful when Dr. Cosgrove said he would tell him. He said, ‘Jake, I have a way to stop the seizures’. When Jake heard that, he punched his right arm straight up in the air and said, ‘yes!’ ‘But’, Dr. Cosgrove continued, ‘ it means you ave to have a little operation.’ ‘Okay,’ Jake replied and then said to me, ‘can we go to the gift shop now?’… Jake was very much into Star Wars at the time and called Dr. Cosgrove his Jedi knight the savior who would make everything bad go away.”

excerpts from an interview with Jake’s mother

The following clinical
profiles provide more detail about Callie, Alex, Jake and Sam and the care they received at MassGeneral Hospital for Children.

Callie. Callie presented at age four years with a several day history of increasing headache, nausea, and drowsiness. ACT scan showed severe hydrocephalus secondary to a pineal gland tumor. An emergency shunt operation was done to relieve the raised intracranial pressure. The following week her benign pineal tumor was successfully removed in a six-hour operation. She has since then remained a normal, energetic child with no evidence of further difficulty on careful follow-up.

Jake. Jake presented at age 7 years old with severe, intractable seizures. He had a congenital left hemiparesis likely as
the result of some perinatal/intrauterine insult. This left him with little or no useful movement of the left hand or arm, a weak left leg and a left homonymous hemianopsia. Nevertheless, he was able to run, attend school, play with his friends etc.

Video/EEG monitoring captured numerous seizures with a presumed right sided onset but these were poorly localized. MRI demonstrated a large porencephalic cyst and gliosis throughout the right hemisphere.

Jake had a large subdural grid of subdural electrodes implanted into his head over the right hemisphere to more accurately determine where the seizures began. The invasive EEG studies demonstrated seizure onset from the scarred cortex surrounding the cyst. We therefore performed a right functional hemispherectomy. He has done extremely well since surgery with no new neurological deficits. He has remained seizure free and is back at school and sports. He recently graduated from third grade with improved grades and is active in tennis, swimming and soccer.