Pediatric Neurosurgery

Author(s):  
Jodi L. Smith

The ABNS Oral Examination evaluates an applicant’s knowledge and judgment in clinical neurosurgical practice after an applicant has been an independent practitioner. With the new format, the oral exam is divided into 3 sessions, each consisting of 5 questions. Questions in the first session deal with general neurosurgery, questions in the second session focus on the preidentified area of practice chosen by the applicant (e.g., pediatric neurosurgery), and questions in the third session are based on cases submitted by the applicant. Common pediatric neurosurgical problems treated by neurosurgeons may be included on the American Board of Neurological Surgery Oral Examination in the general neurosurgery session. Therefore, one should be familiar with the neurosurgical management of pediatric cases, including disorders of cerebrospinal fluid dynamics, congenital cranial and spinal malformations, tumors, vascular congenital and acquired disorders, intracranial and spinal infections, and intractable epilepsy. In this chapter, clinical vignettes of common pediatric neurosurgical conditions will be presented including (a) myelomeningocele, (b) craniosynostosis, (c) hydrocephalus, (d) posterior fossa tumors, and (e) moyamoya disease, with the cases subdivided into those that may be seen in the general session (1 to 3) and those more likely to be seen in the subspecialty specific session (4 and 5). The applicant will be given the history, physical examination, pertinent imaging studies, and test results and will then be expected to provide a rational differential diagnosis and plan of management, outline the risks of surgery, and describe the operation, if proposed, and handle intraoperative and postoperative complications that occur.

Author(s):  
Jodi L. Smith

Common pediatric neurosurgical problems treated by neurosurgeons will be included on the American Board of Neurological Surgeons (ABNS) Oral Board Examination. Therefore, the candidate should be familiar with the neurosurgical management of such problems, which include disorders of cerebrospinal fluid (CSF) dynamics, congenital cranial and spinal malformations, tumors, vascular congenital and acquired disorders, intracranial and spinal infections, and intractable epilepsy. Neurological disorders that mimic pediatric neurosurgical conditions may also be on the examination. In this chapter, clinical vignettes of common pediatric neurosurgical conditions are presented, including hydrocephalus, myelomeningocele, intraventricular hemorrhage (IVH) of prematurity, craniosynostosis, and posterior fossa tumors. The examinee will be given the history, physical examination, pertinent imaging studies, and test results and will then be expected to provide a rational differential diagnosis and plan of management, outline the risks of surgery and describe the operation if proposed, and handle intraoperative and postoperative complications that occur.


Part of the Neurosurgery by Example series, this volume on pediatric neurosurgery presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, aftercare, and complication management of common and uncommon disorders. As pediatric neurosurgery approximates the anatomical and pathophysiological breadth of all specialty areas of adult neurosurgery, the cases provided are particularly relevant to and more frequently encountered in pediatric practice. They also reflect aspects of clinical presentation and management that are notably distinct in pediatric compared to adult neurosurgery. Each chapter also contains “pivot points” that illuminate changes required to manage patients in alternate or atypical situations, and “pearls” for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Pediatric Neurosurgery is appropriate for neurosurgeons who wish to learn more about this subspecialty and those preparing for the American Board of Neurological Surgery oral examination.


2010 ◽  
Vol 38 (5) ◽  
pp. 377-386 ◽  
Author(s):  
Theodorus G. Mettes ◽  
Wil J.M. van der Sanden ◽  
Leontien van Eeten-Kruiskamp ◽  
Jan Mulder ◽  
Michel Wensing ◽  
...  

2018 ◽  
Vol 21 (6) ◽  
pp. 650-654 ◽  
Author(s):  
Christopher M. Bonfield ◽  
Rachel Pellegrino ◽  
Jillian Berkman ◽  
Robert P. Naftel ◽  
Chevis N. Shannon ◽  
...  

OBJECTIVEBoth the American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Section on Pediatric Neurological Surgery (AANS/CNS Pediatric Section) and the International Society for Pediatric Neurosurgery (ISPN) annual meetings provide a platform for pediatric neurosurgeons to present, discuss, and disseminate current academic research. An ultimate goal of these meetings is to publish presented results in peer-reviewed journals. The purpose of the present study was to investigate the publication rates of oral presentations from the 2009, 2010, and 2011 AANS/CNS Pediatric Section and ISPN annual meetings in peer-reviewed journals.METHODSAll oral presentations from the 2009, 2010, and 2011 AANS/CNS Pediatric Section and ISPN annual meetings were reviewed. Abstracts were obtained from the AANS/CNS Pediatric Section and ISPN conference proceedings, which are available online. Author and title information were used to search PubMed to identify those abstracts that had progressed to publication in peer-reviewed journals. The title of the journal, year of the publication, and authors’ country of origin were also recorded.RESULTSOverall, 60.6% of the presented oral abstracts from the AANS/CNS Pediatric Section meetings progressed to publication in peer-reviewed journals, as compared with 40.6% of the ISPN presented abstracts (p = 0.0001). The journals in which the AANS/CNS Pediatric Section abstract-based publications most commonly appeared were Journal of Neurosurgery: Pediatrics (52%), Child’s Nervous System (11%), and Journal of Neurosurgery (8%). The ISPN abstracts most often appeared in the journals Child’s Nervous System (29%), Journal of Neurosurgery: Pediatrics (14%), and Neurosurgery (9%). Overall, more than 90% of the abstract-based articles were published within 4 years after presentation of the abstracts on which they were based.CONCLUSIONSOral abstract presentations at two annual pediatric neurosurgery meetings have publication rates in peer-reviewed journal comparable to those for oral abstracts at other national and international neurosurgery meetings. The vast majority of abstract-based papers are published within 4 years of the meeting at which the abstract was presented; however, the AANS/CNS Pediatric Section abstracts are published at a significantly higher rate than ISPN abstracts, which could indicate the different meeting sizes, research goals, and resources of US authors compared with those of authors from other countries.


2011 ◽  
Vol 7 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Courtney Pendleton ◽  
Edward S. Ahn ◽  
George I. Jallo ◽  
Alfredo Quiñones-Hinojosa

As neurological surgery began developing into a surgical subspecialty in the US at the turn of the 20th century, with Harvey Cushing at the forefront, the operative treatment of spinal dysraphism was refined with attempts to minimize complications. Following institutional approval, and through the courtesy of the Alan Mason Chesney Archives, the authors reviewed the Johns Hopkins Hospital surgical files from 1896 to 1912. Patients presenting with spinal dysraphism who underwent surgical intervention by Dr. Harvey Cushing were selected for further analysis. Ten patients presented for surgical intervention for spinal dysraphism, and 7 of these had concurrent hydrocephalus. The mean age of these patients was 5.8 months (range 1–14 months). The mean length of stay was 20.4 days. There were 6 inpatient deaths. At the time of last follow-up, 2 patients were well, 1 patient remained unimproved, and 1 patient (for whom no discharge outcome was available) had died. The cases described in detail offer insight into the breadth of Cushing's practice and the varied approaches he employed. The use of Faradic stimulation to assess nerve root function, the use of complex multilayered closures, and the creation of operative tables for combined treatment of hydrocephalus and spinal dysraphism illustrate Cushing's contributions to developing the field of pediatric neurosurgery.


2020 ◽  
Vol 2 (2(May-August)) ◽  
pp. e472020
Author(s):  
Ricardo Santos De Oliveira

James Tait Goodrich was born on April 16, 1946 in Portland, Oregon, United States, the son of Richard Goodrich and Gail (Josselyn) Goodrich. Dr. Goodrich served as a Marine officer during the Vietnam War, during which time he decided his next step would be to pursue a medical career. Not only was he an elite surgeon, but over the years he was also a generous mentor and teacher who shared his craft with many young surgeons who wanted to follow in his footsteps. During the Tet Offensive, he spotted a Vietnamese surgeon in a medical tent opening up a soldier’s head. “Cool,” he thought. “I want to do that” (1). Upon return to the USA, Jim married Judy Loudin on December 27, 1970,  the love of his life who gave him the confidence and support to pursue his dreams. Dr. Goodrich completed his undergraduate work at the University of California, Irvine and his graduate studies at the School of Arts and Sciences of Columbia University (1972), receiving his Masters and Doctor of Philosophy degrees in 1978 and 1980, respectively. He received his Medical Degree from Columbia University College of Physicians and Surgeons. After an internship at Columbia- Presbyterian Medical Center (1980-1981), he completed his residency training at the Presbyterian Hospital in New York City and the New York Neurological Institute (1981-1986). He also holds the rank of Professor Contralto of Neurological Surgery at the University of Palermo in Palermo, Italy. He was Director of the Division of Pediatric Neurosurgery at the Children’s Hospital of Montefiore Health System and he served as a Professor of Clinical Neurological Surgery, Pediatrics, Plastic and Reconstructive Surgery at the Albert Einstein College of Medicine since 1998 (2). Dr. James T. Goodrich dedicated his life to saving children with complex neurological conditions. He had a particular interest in the treatment of craniofacial  abnormalities. He was a pioneer in this field and developed a multi-stage approach for separating craniopagus twins who have their brain and skull conjoined. In 2016, he famously led a team of 40 doctors in a 27-hour procedure to separate the McDonald twins. Throughout his distinguished career, he became known as the world’s leading expert on this lifesaving procedure. He has been consulted on hundreds of cases, and he routinely traveled the world sharing his vast knowledge and expertise with colleagues (3,4). In Brazil, Dr. Goodrich played a very important role in leading the processes to successfully separate craniopagus sets in Ribeirao Preto (2017-2018), and in Brasilia (2019). A classical multistage surgery was performed to separate the Ribeirao Preto conjoined twins, and Dr. Goodrich participated on all the neurosurgical procedures as a great mentor. In the final operation, on October 28, 2019, some members of Montefiore Hospital medical staff (Dr. Oren Tepper, plastic surgeon, Dr. Carlene Broderick, pediatric anesthesiologist and Kamilah A. Dowling, nurse) also worked alongside Jim and the Brazilian team.  An extraordinary and humble man, his words after the first surgical step, during an interview for a TV channel, were that in “this particular surgery we were able to do more than we expected because the anatomy was very good and the team had exceptional skills that made the difference”. Dr. Goodrich was a chief supporter of the Latin American Pediatric Neurosurgery Course (LACPN), having participated in all editions since 2004. In these events, he did not hesitate to share his knowledge during the hands-on sessions and, likewise, his wonderful conferences. Prof. Goodrich was officially honored by the Brazilian Society for Pediatric Neurosurgery during the “XII Brazilian Congress of Pediatric Neurosurgery”, in Florianopolis, Brazil.  Dr. Goodrich was a gentle and truly caring man. He did not crave the limelight and was beloved by his colleagues and staff. He has authored numerous book chapters and articles on Pediatric Neurosurgery and is known worldwide as a prominent lecturer in this field. Outside his work, he was also known for his passion for historical artifacts, travelling, wine, and surfing. Dr. Goodrich was an incredible human being. In March 30th, 2020, he passed away after complications due to Covid-19 (5). In that day the world has become a little less bright without Jim. Our sympathy and prayers go to his wife Judy, his three sisters, and all those who were close to him


2021 ◽  
Vol 45 (3) ◽  
pp. 518-525
Author(s):  
Anne R. Crecelius ◽  
Lara R. DeRuisseau ◽  
Josef Brandauer

Assessment methods vary widely across undergraduate physiology courses. Here, a cumulative oral examination was administered in two sections of a 300-level undergraduate physiology course. Student performance was quantified via instructor grading using a rubric, and self-perceptions ( n = 55) were collected via survey. Overall, students affirmed that the oral examination assisted in their learning, specifically by leading them to begin preparation for their final written exam earlier than they otherwise would. The instructor considered the oral exam useful for student learning by providing a scaffold to the written final exam and a way to connect with students before a high-stakes final exam. Specific details of the examination format and suggestions and considerations for those considering this assessment approach are provided.


Author(s):  
Florence W. Kaslow

This chapter discusses ABPP oral examinations. The information provided in this chapter is structured in such a way as to provideadvice and discuss the initial steps in the process so that you will increasethe likelihood of a successful oral examination, such as acquiring a mentor, exam preparation, submission of the practice sample, preparation of a ‘Philosophy of Practice’ statement, as well as what to expect from the oral examination.


Author(s):  
Robert M. Starke

This chapter describes the process of preparing for the American Board of Neurological Surgery (ABNS) Oral Board Examination. This lengthy process is required to attain ABNS confirmation as a board-certified neurosurgeon. This includes the necessary timing for application, accrual of necessary cases, online portal, application for oral examination and certification following case submission, and the ABNS assessment of candidates’ eligibility for oral examination. Each candidate must now submit their prospective cases to the Practice and Outcomes Surgical Therapies (POST) online portal. This chapter reviews the steps in this process to help candidates successfully deliver their cases. Additionally, the chapter reviews study techniques and mentorship guidance.


2019 ◽  
Vol 23 (4) ◽  
pp. 517-522
Author(s):  
Jeffrey L. Nadel ◽  
R. Michael Scott ◽  
Susan R. Durham ◽  
Cormac O. Maher

OBJECTIVEThe goal of this study was to evaluate trends in pediatric neurosurgical fellowship training in North America.METHODSFrom a database maintained by the Accreditation Council for Pediatric Neurosurgery Fellowships (ACPNF), all graduates of ACPNF-accredited pediatric neurosurgery fellowships were identified, and an Internet search was conducted to determine sex, undergraduate and graduate degrees, location and dates of residency and fellowship training, current practice/employment environment, American Board of Neurological Surgery (ABNS) or Fellowship of the Royal College of Surgeons certification status, American Board of Pediatric Neurological Surgery (ABPNS) certification status, and extent of current pediatric-focused practice. The graduates were further studied to determine whether they had completed a neurosurgical residency at a program with an affiliated ACPNF-accredited pediatric neurosurgery fellowship program, and their residency training programs were further classified by whether the program was ranked in the top 50 by NIH funding awards. Each fellowship graduate’s current practice was also ranked in a similar fashion.RESULTSThere were 391 graduates of ACPNF-accredited pediatric neurosurgery fellowship programs from 1993 to 2018. The number of graduates per year has grown steadily over time, as has the percentage of women, now over 40% compared to zero in the first 3 years of fellowship accreditation in the mid-1990s. Approximately 71% of graduating fellows have a pediatric-focused practice, but only 63% went on to attain ABPNS certification. Of all graduates practicing in the United States, 68% practice in academic settings. Ninety-five percent of graduating fellows who were ABNS board eligible were ABNS certified.CONCLUSIONSA study of the graduates of accredited pediatric neurosurgical fellowships from 1993 to 2018 has revealed a growth in the number of graduates from ACPNF-accredited fellowship programs over time. A substantial portion of graduates will practice at least some adult neurosurgery and not go on to obtain ABPNS board certification.


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