What We Treat
As one of the nation’s top 25 programs in neurosurgery, according to U.S. News & World Report, the Pediatric Neurosurgery Program at The Mount Sinai Hospital has the combined expertise to treat a full range of complex pediatric neurological disorders, including the following:
One in 5,000 newborns is born each year with craniosynostosis, a congenital condition that occurs when the bones of the skull close prematurely. As a result of the premature fusion, the head and skull develop abnormally, affecting vital structures of the brain. Some of the most common craniosynostosis conditions treated at Mount Sinai include:
- Coronal synostosis: A condition in which the coronal sutures (related to the crown of the skull) close prematurely, leading to head and facial asymmetry
- Metopic synostosis: A deformity that causes a triangular forehead
- Sagittal synostosis: This disorder causes the head to become long and narrow
At Mount Sinai, our patients receive comprehensive care from the time of diagnosis through surgical treatment and recovery. Our Pediatric Neurosurgery Program is one of few in the tri-state area to provide a minimally invasive surgery option to correct a craniofacial disorder.
This surgical procedure uses a gentle endoscope to release the stuck suture causing the deformity. This procedure is typically done in newborns so the brain can continue to develop and grow normally into its correct shape. Following the procedure, our multidisciplinary group of plastic surgeons, geneticists, physical therapists, ophthalmologists and oral surgeons will continue to collaborate to ensure our pediatric patients are receiving the best of follow-up care.
Known as AVMs, arteriovenous malformations are tangles of abnormal blood vessels that can occur anywhere in the body, but these mostly affect the brain. In children, the condition is often congenital (present at birth) and is thought to occur during fetal development in the first trimester of pregnancy. AVMs can be detected through advanced MRI or CT imaging, but these are typically found incidentally.
Our multidisciplinary team of neurologists, neurosurgeons, vascular specialists, and pediatricians work together to provide tailored treatment plans for children with this condition. The treatment plan may involve a procedure to embolize the blood vessel (to inject materials into the vessel to create a blockage) and to then remove the tangled vessels. For AVMs that are located deep in the brain, stereotactic radiation is another advanced treatment option for pediatric patients. The goal of treatment is to prevent future hemorrhage of the blood vessels in the brain.
In addition to providing excellent care, our dedicate physician-scientists are publishing clinical research on the embolization treatment for AVMs
In collaboration with neurologists at the Mount Sinai Epilepsy Center, our neurosurgeons are committed to working with families to provide the best care for children with epilepsy. With more than 200,000 children diagnosed with epilepsy a year, according to the Epilepsy Foundation, management of spontaneous seizures is essential.
At Mount Sinai, we offer medication management for children with this condition, which can sometimes be temporary. However, for children with chronic epilepsy, surgical intervention is necessary to prevent permanent damage to the child’s developing brain. The surgical treatment involves the removal of the area of the brain responsible for the epilepsy, so that the child can return to his or her normal state of development. Additional options for treatment include deep brain stimulation, if the offending area of the brain is near critical language or memory functions. Our neurosurgeons can recommend the best treatment option to help a child return to a seizure-free life. Ongoing research is being conducted in this area to further knowledge on this innovative treatment.
As a congenital abnormality (present a birth), a chiari malformation occurs when the cerebellum sits below the foramen magnum and pushes into the upper spinal canal. The pressure on the brainstem can affect critical functions and can block the flow of cerebrospinal fluid (sometimes leading to hydrocephalus). While some chiari malformations are asymptomatic, others require surgical intervention.
At Mount Sinai, our neurosurgical team performs a type of minimally invasive surgery to correct this malformation. During the procedure, the bone compressing the brain is removed thereby correcting the abnormality. A team monitors the child’s nervous system using state-of-the-art ultrasound technology as an additional layer of safety. Recovery is very quick and children are usually released within the same day.
Childhood dystonia is a neurological condition that is characterized by twisting of the limbs and painful contractions of muscles, mostly in the foot or hands. The spasms can begin in one area of the body and spread to others. The condition can be caused by a genetic abnormality (primary dystonia) or by an injury to the brain as a result of a car accident, stroke or cerebral palsy (secondary dystonia).
In collaboration with neurologists at the Robert and John M. Bendheim Parkinson and Movement Disorder Center, our pediatric neurosurgical team will develop a personalized treatment plan for your child aimed at improving quality of life. Our Pediatric Neurosurgery Program offers advanced treatment options such as deep brain stimulation for children with primary dystonia through the Center for Neuromodulation and intrathecal pump therapy for children with secondary dystonia.
Pediatric Brain Tumor
Although pediatric brain tumors affect 4,600 children a year, they are the most common solid tumors in children, according to the Pediatric Brain Tumor Foundation. Our pediatric neurosurgeons are experts in diagnosing and treating the most complex brain tumors in children, including:
- Ependymomas: These slow-growing tumors develop in the cells that line the ventricles of the brain and spinal cord.
- Juvenile pilocytic astricytomas (JPA): These benign tumors can cause pressure around the brain and can lead to hydrocephalus (a neurological condition where excess cerebrospinal fluid builds in the brain).
- Medulloblastomas: These fast-growing tumors are located in the lower, rear section of the brain. A surgeon, oncologist, and radiation therapist will deliver therapy to treat this type of tumor.
- Pontine glioma: Arising in the brain stem, these malignant brain tumors are challenging to treat because they interfere with the critical functioning of this area in the brain.
Pediatric Spinal Cord Tumors
Although childhood tumors and cancer are rare, pediatric spinal cord tumors are the third most common solid tumors in children, according to the National Cancer Institute. Whether they are benign or malignant, tumors that press against the spinal cord affect critical functions of the central nervous system. They can also cause symptoms such as back pain, difficulty walking, or weakness in the legs. Our neurosurgeons use advanced diagnostic techniques such as MRI, CT, or PET scans to detect the location and type of spinal cord tumor. Based on the type of tumor, our neurosurgeons might recommend one of the following treatment options, or a combination of all three:
- Radiation therapy
- Surgery (craniotomy)
Treatment plans are conducted by our experienced team of neurologists and neurosurgeons who are experts in treating complex spinal cord tumors in children.
Tethered Spinal Cords
The spinal cord normally hangs loose, allowing for free movement as a child grows and develops. In a tethered spinal cord, the spinal cord does not move freely, and this disrupts the flow of blood, leading to muscle weakness, back pain, difficulty walking, and bowel and bladder dysfunction. Left untreated, the condition can worsen over time and can lead to permanent damage of the spinal cord.
Mount Sinai’s Pediatric Neurosurgery Program provides surgical options for families affected by this condition. With the use of advanced MRI and CT imaging technology, our neurosurgeons can confirm a diagnosis and can provide a detailed treatment plan which may include untethering surgery. Pediatric patients will also have access to specialists in, Neurology, Gastroenterology, and Urology as part of the comprehensive care they will receive.
As one of several movement disorders, spasticity is a condition characterized by involuntary muscle spasms and tightness. The condition is often found in children with cerebral palsy or those with a brain injury. At Mount Sinai, our team of experts in Neurosurgery, Neurology, Orthopaedics, and Physical Therapy collaborate to provide personalized treatment plans based on the goals of care for the child.
Every child is evaluated thoroughly to determine the best course of action, which may include the use of pump therapy. The pump is implanted along the abdominal wall and is designed to deliver concentrated amounts of baclofen, an antispasticity muscle relaxant. As a mainstay treatment, the pump greatly reduces the frequency and severity of spasms, helping children return to their normal routines.
Often associated with chiari malformations or tethered spinal cords, syringomyelia is a condition where a cyst forms along the spinal cord because of excessive cerebrospinal fluid. The cyst, called a syrinx, damages a portion of the spinal cord and its associated nerve fibers as it grows. This can lead to headaches, stiffness in legs, arms, back, and shoulders. It can also interfere with vital functions such as breathing because of the pressure it places on the brainstem.
Mount Sinai’s Pediatric Neurosurgery Program provides advanced surgical treatment to correct the cause of the syringomyelia. Our neurosurgeons will aim to correct abnormalities in the spacing of the skull and neck to resolve the syringomyelia.
1468 Madison Avenue
Annenberg Building 8th floor
New York, NY 10029