A note from Neurosurgeon-in-Chief Mark Proctor, MD

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Contact the Department of Neurosurgery

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In my last note I provided clinical updates on our major neurosurgical programs. This time I’d like to brief you on some exciting research and our recent community initiatives.

Neurosurgery research news

The Pediatric Hydrocephalus Foundation has funded Joseph Madsen, MD, to lead the development of new devices and approaches to hydrocephalus. Madsen and colleagues will address two critical questions:

  • MadsenWhen can we say that hydrocephalus is adequately treated? If the ventricles in a baby stay enlarged after an ETV, for example, we intuitively believe the treatment succeeded. But to move from theory to practice, we need objective evidence, such as improved pulsation absorption or regulated microvascular waveform.
  • What is the origin of symptoms in chronic shunt dysfunction? Many young people have daily headaches after shunting, yet there is no consensus on the treatment of “slit ventricle syndrome” or other post-shunting symptoms. With the new grant, we can move toward a more practical application of pulsation absorber theory to these patients.

Dr. Madsen and his work were recently honored by the Institute for Pediatric Innovation.

BenowitzLarry Benowitz, PhD, our Director of Neuroscience Research in Neurosurgery and a leader in the field of axonal regeneration, was recently awarded one of six U01 grants from the NIH to identify biological factors affecting neural regeneration in the retina. The projects are part of the National Eye Institute’s “Audacious Goals Initiative” aimed at restoring vision.

With Paul Rosenberg, MD, PhD (Neurology) and Eric (Yiqing) Li, MD, PhD, Dr. Benowitz recently uncovered a surprising new regenerative approach: using chelating agents to bind up zinc that’s released as a result of nerve injury and is toxic to retinal ganglion cells. He and collaborators are now investigating what gives rise to free zinc in the retina, the mechanisms that suppress cell survival and nerve regeneration and the potential for translating these discoveries to treat conditions such as glaucoma and spinal cord injury.

StoneSyringomyelia: Boston Children’s Hospital is now part of the Park-Reeves Syringomyelia Consortium. With Scellig Stone, MD, PhD, as site Principial Investigator, we plan to recruit 20 to 25 patients to help improve understanding of the incidence, natural history and short- and long-term treatment outcomes of Chiari I malformation and syringomyelia.

Edward SmithNeurosurgical genetics: Edward Smith, MD, is developing a Genetic Biorepository for patients and their families here at Boston Children’s Hospital to identify the genes responsible for a variety of neurosurgical conditions. The knowledge gained could lead to more refined disease classifications, better diagnostic tools and more effective therapeutic strategies addressing the conditions’ underlying molecular pathophysiology.

Craniofacial repository: In a similar vein, I am participating in a new research protocol to establish a specimen repository for craniofacial, plastic surgery and oral surgery patients, together with John Meara, MD, DMD, and the Craniofacial Center of Excellence. Over time, we hope it will lead to the discovery of novel treatments for a wide array of diseases affecting children.

Meara Proctor
Proctor and John Meara, MD, DMD (Plastic Surgery) reviewing a craniofacial case.

In the community

  • The 14th Annual Sports-Related Concussion and Spine Injury Conference this May hosted 200+ attendees, including physicians, nurses, athletic trainers and physical therapists. Faculty from Boston Children’s and beyond provided updates on current research, tools and guidelines to effectively and safely diagnose and treat athletes in the acute and chronic stages of recovery.
  • Also in May, our Moyamoya Day Family Symposium hosted more than 90 families, with a live stream for those unable to get to Boston. The annual event was hosted by our Cerebrovascular Surgery and Interventions Center.
  • Our efforts continue with the ThinkFirst National Injury Prevention Foundation to prevent brain and spinal cord injury through education, research and advocacy. I’m proud to have been named ThinkFirst’s 2017 Sponsoring Physician of the Year this spring.

As always, we welcome your questions, suggestions and, of course, your consideration when seeking highly specialized services for your patients.

Dr. Mark Proctor
Department of Neurosurgery
Boston Children’s Hospital

Boston Children’s is so much more than a hospital—it’s a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible. ”
- Sandra L. Fenwick, President and CEO

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