"As I reflect on a rewarding career, what matters to me most is the children I have treated and the doctors I have trained—it's a legacy I am proud of."

EDUCATION

Undergraduate Degree

  • Williams College , 1962 , Williamstown , MA

Medical School

  • Temple University School of Medicine , 1966 , Philadelphia , PA

Internship

  • Boston City Hospital , 1967 , Boston , MA

Fellowship

Research
  • National Institute of Neurological Diseases and Stroke , 1969 , Bethesda , MD

Residency

Neurosurgery
  • Massachusetts General Hospital , 1973 , Boston , MA

Philosophy of Care

As I reflect on a rewarding career, what matters to me most is the children I have treated and the doctors I have trained. I lead by example to teach doctors things that can't be found in books: how to talk to patients, how to conduct rounds, how to manage the operating room. It's a legacy I am proud of.

PROFESSIONAL HISTORY

During my tenure as neurosurgeon-in-chief, I have helped to build the Neurosurgery Department at Boston Children's Hospital into a world leader. Together with colleagues, we have trained many of the country's top neurosurgeons. I am proud of my legacy of mentorship and clinical innovation.

In 1985, I made a clinical breakthrough in the treatment of moyamoya disease, a narrowing of the brain's blood vessels that leads to progressive strokes in children. I devised a new surgery, called pial synangiosis, in which I affixed a healthy donor artery to the affected area of a patient’s brain. Our studies have shown that pial synangiosis has proved to be an extremely effective long-term treatment of the condition. This ground-breaking procedure has been successfully performed on more than 500 patients since then, changing outcomes for children with moyamoya and turning our hospital into the leading center worldwide for children with this condition.

I have been fortunate in my career to practice at a time of rapid advances in imaging technology. The advent of CT scans allowed me, together with radiology and pathology colleagues, to diagnose and treat cavernous malformations of the brain. I collaborated with radiologists to use the new technology of MRI to describe and clarify for the first time the structural changes in the brain that occur in children with spina bifida and gain new understanding of their treatment.  

I've had a very fortunate and rewarding career at Boston Children's Hospital. I established the Shillito Pediatric Neurosurgery Fellowship in 1991, which every year supports an outstanding young neurosurgeon as he or she pursues intensive, post-graduate training in pediatric neurosurgery each year. Three of our most distinguished neurosurgical faculty -- Mark Proctor, Ed Smith, Ben Warf -- were trainees of our department.

I am Emeritus Neurosurgeon-in-Chief at Boston Children's Hospital, hold the Fellows Chair in Pediatric Neurosurgery and am a Professor at Harvard Medical School. I completed medical school at Temple University and residency in neurosurgery at Massachusetts General Hospital.

I was honored to receive the Franc D. Ingraham Award for Distinguished Service to Pediatric Neurosurgery from American Association of Neurological Surgery in 2011 and the William Silen Lifetime Achievement Award in Mentoring from Harvard Medical School in 2012. I was the chairman of the American Board of Pediatric Neurosurgery from 2003 until 2008, am currently chairman of the council that accredits pediatric neurosurgical fellowships (ACPNF), and have sat on Boston Children's Hospital's Physician Leadership Committee and Council of Chiefs.

CERTIFICATIONS

  • American Board of Neurological Surgery
  • American Board of Pediatric Neurological Surgery

PUBLICATIONS

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  1. Cavernous malformations. Neurosurg Clin N Am. 2010 Jul; 21(3):483-90. View abstract
  2. Moyamoya: epidemiology, presentation, and diagnosis. Neurosurg Clin N Am. 2010 Jul; 21(3):543-51. View abstract
  3. The use of Onyx for embolization of central nervous system arteriovenous lesions in pediatric patients. AJNR Am J Neuroradiol. 2010 Jan; 31(1):112-20. View abstract
  4. Medical, psychological, cognitive and educational late-effects in pediatric low-grade glioma survivors treated with surgery only. Pediatr Blood Cancer. 2009 Sep; 53(3):417-23. View abstract
  5. Seckel syndrome and moyamoya. J Neurosurg Pediatr. 2009 Apr; 3(4):320-4. View abstract
  6. Pial synangiosis in patients with moyamoya syndrome and sickle cell anemia: perioperative management and surgical outcome. Neurosurg Focus. 2009 Apr; 26(4):E10. View abstract
  7. Introduction: moyamoya disease. Neurosurg Focus. 2009 Apr; 26(4):E1. View abstract
  8. Moyamoya disease and moyamoya syndrome. N Engl J Med. 2009 Mar 19; 360(12):1226-37. View abstract
  9. Identification of an association between Robinow syndrome and moyamoya. Pediatr Neurosurg. 2009; 45(1):69-72. View abstract
  10. Outcome of pediatric pineoblastoma after surgery, radiation and chemotherapy. J Neurooncol. 2008 Aug; 89(1):89-95. View abstract
  11. Urinary biomarkers predict brain tumor presence and response to therapy. Clin Cancer Res. 2008 Apr 15; 14(8):2378-86. View abstract
  12. Progression of disease in unilateral moyamoya syndrome. Neurosurg Focus. 2008; 24(2):E17. View abstract
  13. Tethered cord syndrome. Neurosurg Clin N Am. 2007 Jul; 18(3):531-47. View abstract
  14. A recurrent craniopharyngioma illustrates the potential usefulness of urinary matrix metalloproteinases as noninvasive biomarkers: case report. Neurosurgery. 2007 Jun; 60(6):E1148-9; discussion E1149. View abstract
  15. Wound complications associated with the use of bovine serum albumin-glutaraldehyde surgical adhesive in pediatric patients. Neurosurgery. 2007 Apr; 60(4 Suppl 2):305-9; discussion 309. View abstract
  16. Moyamoya following cranial irradiation for primary brain tumors in children. Neurology. 2007 Mar 20; 68(12):932-8. View abstract
  17. Transcendent leadership: recent advances in pediatric neurosurgery. Clin Neurosurg. 2007; 54:19-22. View abstract
  18. Phase II study of thalidomide and radiation in children with newly diagnosed brain stem gliomas and glioblastoma multiforme. J Neurooncol. 2007 Mar; 82(1):95-101. View abstract
  19. Transverse myelitis after therapy for primitive neuroectodermal tumors. Pediatr Neurol. 2006 Aug; 35(2):122-5. View abstract
  20. Everyday cognitive function after craniopharyngioma in childhood. Pediatr Neurol. 2006 Jan; 34(1):13-9. View abstract
  21. Moyamoya syndrome associated with Down syndrome: outcome after surgical revascularization. Pediatrics. 2005 Nov; 116(5):e694-701. View abstract
  22. Craniopharyngioma: a personal (Boston) experience. Childs Nerv Syst. 2005 Aug; 21(8-9):773-7. View abstract
  23. Diencephalic syndrome: a cause of failure to thrive and a model of partial growth hormone resistance. Pediatrics. 2005 Jun; 115(6):e742-8. View abstract
  24. Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor. J Neurooncol. 2005 Mar; 72(1):77-84. View abstract
  25. Surgical management of moyamoya syndrome. Skull Base. 2005 Feb; 15(1):15-26. View abstract
  26. Stereotactic radiotherapy for localized low-grade gliomas in children: final results of a prospective trial. Int J Radiat Oncol Biol Phys. 2005 Feb 01; 61(2):374-9. View abstract
  27. Craniopharyngioma therapy: long-term effects on hypothalamic function. Neurologist. 2005 Jan; 11(1):55-60. View abstract
  28. Perioperative management of diabetes insipidus in children. J Neurosurg Anesthesiol. 2004 Jul; 16(3):220-5. View abstract
  29. Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis. J Neurosurg. 2004 Feb; 100(2 Suppl Pediatrics):142-9. View abstract
  30. Perioperative management of diabetes insipidus in children [corrected]. J Neurosurg Anesthesiol. 2004 Jan; 16(1):14-9. View abstract
  31. Chemotherapy for progressive low-grade gliomas in children older than ten years: the Dana-Farber experience. Pediatr Hematol Oncol. 2003 Oct-Nov; 20(7):497-504. View abstract
  32. Reoperation for Chiari malformations. Pediatr Neurosurg. 2003 Oct; 39(4):171-8. View abstract
  33. Neuropsychological functioning after surgery in children treated for brain tumor. Neurosurgery. 2003 Jun; 52(6):1348-56; discussion 1356-7. View abstract
  34. Shunt technology: contemporary concepts and prospects. Clin Neurosurg. 2003; 50:256-67. View abstract
  35. Biochemical characterization of pediatric brain tumors by using in vivo and ex vivo magnetic resonance spectroscopy. J Neurosurg. 2002 Jun; 96(6):1023-31. View abstract
  36. Levels of soluble adhesion molecules are elevated in the cerebrospinal fluid of children with moyamoya syndrome. Neurosurgery. 2002 Mar; 50(3):544-9. View abstract
  37. Neuroimaging in pediatric brain tumors: Gd-DTPA-enhanced, hemodynamic, and diffusion MR imaging compared with MR spectroscopic imaging. AJNR Am J Neuroradiol. 2002 Feb; 23(2):322-33. View abstract
  38. Memory deficits among children with craniopharyngiomas. Neurosurgery. 2001 Nov; 49(5):1053-7; discussion 1057-8. View abstract
  39. Craniopharyngioma presenting during pregnancy 4 years after a normal magnetic resonance imaging scan: case report. Neurosurgery. 2001 Oct; 49(4):1014-6; conclusion 1016-7. View abstract
  40. Proton magnetic spectroscopic imaging of the child's brain: the response of tumors to treatment. Neuroradiology. 2001 Feb; 43(2):169-77. View abstract
  41. Long-term outcome for patients with split cord malformation. Neurosurg Focus. 2001 Jan 15; 10(1):e5. View abstract
  42. Surgery for moyamoya syndrome? Yes. Arch Neurol. 2001 Jan; 58(1):128-9. View abstract
  43. The effect of surgery for split spinal cord malformation on neurologic and urologic function. Pediatr Neurosurg. 2000 Jan; 32(1):13-9. View abstract
  44. Moyamoya syndrome: a surgically treatable cause of stroke in the pediatric patient. Clin Neurosurg. 2000; 47:378-84. View abstract
  45. Cervicomedullary astrocytomas of childhood: clinical and imaging follow-up. Pediatr Radiol. 1999 Sep; 29(9):662-8. View abstract
  46. Spontaneous thrombosis of vein of Galen aneurysmal malformation. Pediatr Neurosurg. 1999 Jul; 31(1):33-9. View abstract
  47. Analysis of posterior plagiocephaly: deformational versus synostotic. Plast Reconstr Surg. 1999 Feb; 103(2):371-80. View abstract
  48. Moyamoya syndrome associated with cocaine abuse. Case report. Neurosurg Focus. 1998 Nov 15; 5(5):e7. View abstract
  49. American Society of Pediatric Neurosurgeons--change at the millennium. Pediatr Neurosurg. 1998 Nov; 29(5):225-7. View abstract
  50. Neurologic complications of cerebral angiography in childhood moyamoya syndrome. Pediatr Radiol. 1998 Nov; 28(11):824-9. View abstract
  51. Familial intracranial arteriovenous malformations. Case report and review of the literature. Pediatr Neurosurg. 1998 Oct; 29(4):208-13. View abstract
  52. Cerebral vasculopathy and neurologic sequelae in infants with cervicofacial hemangioma: report of eight patients. Radiology. 1998 Jun; 207(3):601-7. View abstract
  53. Focal cortical dysplasia with glioproliferative changes causing seizures: report of 3 cases. Pediatr Neurosurg. 1998 May; 28(5):261-6. View abstract
  54. The use of clinical practice guidelines (CPGs) to evaluate practice and control costs in ventriculoperitoneal shunt management. Surg Neurol. 1997 Dec; 48(6):536-41. View abstract
  55. Synostotic frontal plagiocephaly: anthropometric comparison of three techniques for surgical correction. Plast Reconstr Surg. 1997 Nov; 100(6):1387-95. View abstract
  56. Childhood optic chiasm gliomas: radiographic response following radiotherapy and long-term clinical outcome. Int J Radiat Oncol Biol Phys. 1997 Oct 01; 39(3):579-87. View abstract
  57. Elevation of cerebrospinal fluid levels of basic fibroblast growth factor in moyamoya and central nervous system disorders. Pediatr Neurosurg. 1997 Oct; 27(4):182-9. View abstract
  58. Optic chiasm astrocytomas of childhood. 1. Long-term follow-up. Pediatr Neurosurg. 1997 Sep; 27(3):121-8. View abstract
  59. Optic chiasm astrocytomas of childhood. 2. Surgical management. Pediatr Neurosurg. 1997 Sep; 27(3):129-36. View abstract
  60. Intracranial germinoma: the case for lower dose radiation therapy. Int J Radiat Oncol Biol Phys. 1997 Sep 01; 39(2):419-26. View abstract
  61. Childhood moyamoya disease: hemodynamic MRI. Pediatr Radiol. 1997 Sep; 27(9):727-35. View abstract
  62. Angiographic changes after pial synangiosis in childhood moyamoya disease. AJNR Am J Neuroradiol. 1997 May; 18(5):837-45. View abstract
  63. Late effects of early surgery on lipoma and lipomeningocele in children less than 1 year old. J Urol. 1997 Apr; 157(4):1434-7. View abstract
  64. Presentation and management of Chiari I malformation in children. Pediatr Neurosurg. 1997 Apr; 26(4):190-6. View abstract
  65. Postoperative cerebral edema occurring in children with slit ventricles. Pediatrics. 1997 Apr; 99(4):625-30. View abstract
  66. Spontaneous rapid resolution of an epidural hematoma associated with an overlying skull fracture and subgaleal hematoma in a 17-month-old child. Pediatr Neurosurg. 1997 Mar; 26(3):160-5. View abstract
  67. Hemorrhagic pituitary adenomas of adolescence. AJNR Am J Neuroradiol. 1996 Nov-Dec; 17(10):1907-12. View abstract
  68. Jugular foraminal stenosis in Crouzon syndrome. Pediatr Neurosurg. 1996 Nov; 25(5):252-5. View abstract
  69. Moyamoya and Down syndrome. Clinical and radiological features. Stroke. 1996 Nov; 27(11):2131-5. View abstract
  70. Giant cell ependymoma of the filum terminale. A report of two cases. Am J Surg Pathol. 1996 Sep; 20(9):1091-101. View abstract
  71. Immunohistochemically identifiable tissue plasminogen activator in cavernous angioma: mechanism for re-hemorrhage and lesion growth. Pediatr Neurosurg. 1996 Sep; 25(3):137-41; discussion 141-2. View abstract
  72. Magnetic resonance imaging changes after stereotactic radiation therapy for childhood low grade astrocytoma. Cancer. 1996 Aug 15; 78(4):864-73. View abstract
  73. How would you treat this patient? Dysembryoplastic neuroepithelial tumor. Surg Neurol. 1996 Jul; 46(1):23-7. View abstract
  74. The critical importance of stimulus intensity in intraoperative monitoring for partial dorsal rhizotomy. Muscle Nerve. 1996 Apr; 19(4):415-22. View abstract
  75. Acquired cerebral arteriovenous malformation in a child with moyamoya disease. Case report. J Neurosurg. 1996 Apr; 84(4):677-80. View abstract
  76. Neurophysiologic assessment of urinary dysfunction in children with thoracic syringomyelia. J Child Neurol. 1995 Nov; 10(6):451-4. View abstract
  77. Nonrandom chromosomal gains in pilocytic astrocytomas of childhood. Hum Pathol. 1995 Sep; 26(9):979-86. View abstract
  78. Nitrous oxide depresses the H-reflex in children with cerebral palsy. Anesth Analg. 1995 Feb; 80(2):239-41. View abstract
  79. Pial synangiosis for moyamoya syndrome in children. Pediatr Neurosurg. 1995; 23(1):26-33. View abstract
  80. Clinicopathologic and cytogenetic analysis of malignant rhabdoid tumor of the central nervous system. J Neurooncol. 1995; 25(3):193-203. View abstract
  81. De novo Chiari-I malformation in infants demonstrated by sequential magnetic resonance imaging scans. Report of two cases. Pediatr Neurosurg. 1995; 22(6):299-302. View abstract
  82. Stereotactic radiotherapy for pediatric and adult brain tumors: preliminary report. Int J Radiat Oncol Biol Phys. 1994 Oct 15; 30(3):531-9. View abstract
  83. Microvessel count and cerebrospinal fluid basic fibroblast growth factor in children with brain tumours. Lancet. 1994 Jul 09; 344(8915):82-6. View abstract
  84. Doppler sensor placement during neurosurgical procedures for children in the prone position. J Neurosurg Anesthesiol. 1994 Jul; 6(3):153-5. View abstract
  85. H reflex studies in cerebral palsy patients undergoing partial dorsal rhizotomy. Muscle Nerve. 1994 May; 17(5):539-49. View abstract
  86. Advances in radiation therapy for craniopharyngiomas. Pediatr Neurosurg. 1994; 21 Suppl 1:101-7. View abstract
  87. Surgery, radiation, and combination therapy in the treatment of childhood craniopharyngioma--a 20-year experience. Pediatr Neurosurg. 1994; 21 Suppl 1:75-81. View abstract
  88. Seizures in children with supratentorial astroglial neoplasms. Pediatr Neurosurg. 1994; 21(1):23-30. View abstract
  89. The neurosurgical implications of continuous neurourological surveillance of children with myelodysplasia. J Urol. 1993 Dec; 150(6):1879-83. View abstract
  90. Anesthetic management of children with moyamoya syndrome. Anesth Analg. 1993 Nov; 77(5):1066-70. View abstract
  91. Pediatric and adolescent oligodendrogliomas. AJNR Am J Neuroradiol. 1993 Nov-Dec; 14(6):1293-300. View abstract
  92. 20-year experience in childhood craniopharyngioma. Int J Radiat Oncol Biol Phys. 1993 Sep 30; 27(2):189-95. View abstract
  93. Effect of surgical repair on the neurologic function in infants with lipomeningocele. Pediatr Neurosurg. 1993 Sep-Oct; 19(5):256-9. View abstract
  94. Chiari malformations, syringomyelia, and intramedullary spinal cord tumors. Curr Opin Neurol Neurosurg. 1993 Aug; 6(4):559-63. View abstract
  95. Thallium-201 versus technetium-99m-MIBI SPECT in evaluation of childhood brain tumors: a within-subject comparison. J Nucl Med. 1993 Jul; 34(7):1045-51. View abstract
  96. Prognostic factors in medulloblastoma, including DNA ploidy. J Clin Oncol. 1993 Apr; 11(4):616-22. View abstract
  97. Epidural hematomas in children. Ann Emerg Med. 1993 Mar; 22(3):535-41. View abstract
  98. Tethered spinal cord in patients with anorectal and urogenital malformations. Pediatr Neurosurg. 1993; 19(1):25-30. View abstract
  99. Continuous urodynamic surveillance of babies with myelodysplasia: implications for further neurosurgery. Eur J Pediatr Surg. 1992 Dec; 2 Suppl 1:35-6. View abstract
  100. Bladder functional changes resulting from lipomyelomeningocele repair. J Urol. 1992 Aug; 148(2 Pt 2):592-4. View abstract
  101. Intracranial melanotic neuroectodermal tumor of infancy: two case reports. Surg Neurol. 1992 Feb; 37(2):123-9. View abstract
  102. Cavernous angiomas of the central nervous system in children. J Neurosurg. 1992 Jan; 76(1):38-46. View abstract
  103. The change in patterns of relapse in medulloblastoma. Cancer. 1991 Oct 01; 68(7):1600-4. View abstract
  104. 201Tl/99mTc-HMPAO SPECT imaging of treated childhood brain tumors. Pediatr Neurol. 1991 Jul-Aug; 7(4):249-57. View abstract
  105. Transfalcine approach to a callosomarginal artery aneurysm. Neurosurgery. 1991 Jul; 29(1):140-3. View abstract
  106. The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery. 1991 May; 28(5):666-71; discussion 671-2. View abstract
  107. Clival chondroma in a child with Ollier's disease. Case report. Pediatr Neurosurg. 1991-1992; 17(1):53-6. View abstract
  108. The fellowship in pediatric neurosurgery. Pediatr Neurosurg. 1991-1992; 17(6):281-3. View abstract
  109. Brain stem cavernous angiomas in children. Pediatr Neurosurg. 1990-1991; 16(6):281-6. View abstract
  110. Pre-irradiation chemotherapy for infants and children with medulloblastoma: a preliminary report. J Neurosurg. 1989 Dec; 71(6):820-5. View abstract