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

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Today I’d like to share several new research initiatives underway here at Boston Children’s, as well as a new Visiting Professorship. But most immediately, as of late December, we have an update on ETV/CPC that should help settle the question of whether this shunt-sparing operation provides equally good cognitive outcomes.

Researchers led by ETV/CPC’s developer, Benjamin Warf, MD, randomized 100 infants at the CURE Children’s Hospital of Uganda to receive either ETV/CPC or a shunt. They report in The New England Journal of Medicine that both groups had similar brain volumes and cognitive scores at 12 months, although the shunt group, as expected, had lower CSF volumes. Warf and colleagues will continue to follow these patients, but in the meantime, we hope these findings will encourage greater adoption of ETV/CPC. Read more on our science blog.

New research initiatives

AVM growth drivers

Ed Smith, MD, PhD, director of Pediatric Cerebrovascular Neurosurgery has received a Warner Family Translational Research Pilot Grant together with co-PIs Arin Greene, MD (Plastic Surgery), Darren Orbach MD, PhD (Cerebrovascular Surgery and Interventions Center) and Mustafa Sahin, MD, PhD (Translational Neuroscience Center). Under the two-year, multi-departmental grant, Smith and colleagues will compare intracranial and extracranial arteriovenous malformations to identify drivers of AVM development.

DBS for primary dystonia

Boston Children’s began offering deep brain stimulation (DBS) for primary dystonia in 2015. Now that the neurostimulator, from Medtronic, has been designated a Humanitarian Use Device by the FDA, Scellig Stone, MD, PhD, is offering DBS to all patients seen in Neurology or Neurosurgery for primary dystonia that is refractory to medical therapy.

Predicting large-scale blood loss during craniosynostosis repair

My own group is completing a prospective study of predictors of substantial blood loss during craniosynostosis repair, in collaboration with John Meara, MD, DMD, MBA (Plastic Surgery) and Petra Meier-Haran, MD (Anesthesiology). Patients received standardized anesthetic and fluid management and had thromboelastographic parameters and platelet fibrinogen products measured at predefined times. Outcomes of interest are intraoperative blood loss and the need for packed red blood cells and coagulation products.

Program news

R. Michael Scott Visiting Professorship

A new annual visiting professorship and lecture is being established for 2018 in honor of R. Michael Scott, MD, our Neurosurgeon-in-Chief Emeritus. In keeping with Mike’s tremendous impact on pediatric neurosurgery, we will invite leaders who are world-class speakers and embody Mike’s combination of clinical expertise, innovation and dedication to teaching. The first visiting professor will be Jeffrey H. Wisoff, MD, professor and director of the Division of Pediatric Neurosurgery at NYU’s Langone Medical Center. His lecture is scheduled for April 4, 2018.

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

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