Neurosurgery

The Section of Neurosurgery at Nationwide Children's provides the best possible care to all pediatric patients with neurosurgical needs through advanced surgical techniques for rare brain tumors, epilepsy, craniosynostosis and Chiari malformations as well as urgent interventions for injuries due to trauma or stroke.

In our state-of-the-art operating room, our staff uses central Ohio’s only pediatric intraoperative MRI (iMRI). One of the main benefits of iMRI technology is the ability to use it during tumor removal. The use of the iMRI enables the neurosurgeon to look for remaining tumor or any other abnormalities during an operation, thus reducing the chance for multiple operations. Additional advanced technologies used in our operating suites include neuroendoscopes, computerized navigation systems, intraoperative ultrasound and minimally invasive laser ablation.

The experience and expertise of our neurosurgical team, and our access to leading-edge technology, allow us to provide the most advanced, minimally invasive care appropriate for every case.
Jeffrey R. Leonard, MD
Chief of Neurosurgery

Our neurosurgeons collaborate with Neurology, Physical Medicine and Rehabilitation, Plastic and Reconstructive Surgery, Hematology, Oncology and Blood and Marrow Transplant and many others to promote positive outcomes for neurosurgical patients from birth to age 21, and for selected adults with congenital neurological disorders. Our surgeons value collaborative relationships with primary care physicians and believe in maintaining communication to support ongoing patient care.

As part of the Level 1 Trauma Program, our neurosurgeons provide round-the-clock coverage for the Emergency Department, enabling us to achieve best outcomes for patients with traumatic brain injuries.

“There is no delay in care – from the time the patient comes into the Emergency Department through triage, imaging and surgery. We know that with traumatic brain injuries every minute counts,” says Dr. Leonard.

Our team’s expertise includes minimally invasive endoscopic procedures to decrease the impact on the patient, minimize pain and promote faster recovery. We also specialize in minimally invasive treatment of intraventricular pathology and brain tumors, when appropriate.

In the growing field of epilepsy surgery, we are leading the way with innovative, patient-centered care and ground-breaking collaborative research. Through the Epilepsy Research Program, a team of neurosurgeons and neurologists is working to develop numerous studies from mathematical modeling of EEG changes to building an epilepsy surgery database and creating an algorithm for analyzing histopathology samples from surgery.

3,880 Clinic visits in 2015
610 Surgical cases in 2015
1 Fellowship/residency programs
4 Number of surgical faculty
Stopping Gaige’s Seizures

If he stayed up late, Gaige had a seizure. When he got too excited about an upcoming family event, the arrival of Christmas or his birthday, he had a seizure. If he exerted himself while playing basketball, he had a seizure.

When the seizures started at 3 years old, Gaige had a couple per week. As he grew, they became more frequent and difficult to manage.

At one point, Gaige was having nine to 10 seizures a week, sometimes more than one in the same night.

“He kept the television on all night so that he could identify where he was once his seizure stopped,” says his grandmother, Stefanie. “The television, always tuned to the Disney station, helped him recognize that he was at home, safe.”

At age 11, Gaige was diagnosed with the congenital brain disorder cortical dysplasia and had a one-stage epilepsy brain surgery. During that surgery the abnormal-looking portion of his brain was removed.

The surgery stopped Gaige’s seizures for about nine months, but then they began again – more frequent than ever. His short term memory faltered. He had difficulty remembering what he was learning in school. He had to relearn the same material each day.

Because medication didn’t reduce the number of seizures, Gaige underwent a two-stage epilepsy brain surgery.

“For patients with epilepsy who do not respond well to medication, the epilepsy surgery can be an effective way to eliminate or reduce seizures and greatly improve quality of life,” says Jonathan Pindrik, MD, neurosurgeon at Nationwide Children’s.

Two-Stage Surgery for Medically Refractory Epilepsy

Surgery for epilepsy is performed when pharmaceutical management fails to limit satisfactorily the frequency and severity of seizures a patient experiences. In many cases, patients are not able to function in everyday life because of the seizures.

Two-stage epilepsy surgery consists of four main steps: Phase I monitoring, Stage I surgery, Phase II monitoring and Stage II surgery.

Phase I monitoring was conducted by neurologist Satyanarayana Gedela, MD. In the Stage I surgery, Dr. Pindrik performed a craniotomy for grid insertion. Then, a grid composed of strips of electrodes embedded in a thin, flexible sheet of polyurethane was surgically placed over and around areas suspected to be linked to the seizures. Gaige’s wound was closed with electrode tails and drains emerging from the skin.

In Phase II monitoring, the team used the grid to pinpoint where the seizures started and, by stimulating the electrodes, mapped the functional areas of Gaige’s brain. At the end of one week, the grid was removed, along with parts of the brain that were causing or could cause seizures and any structurally abnormal parts during the Stage II surgery.

Since that two-stage epilepsy surgery, Gaige, now 16 years old, has not had a seizure. He pays attention in class, does lessons on his own and reads words that he has struggled with for years. In gym class, he participates in all the activities and no longer worries that if he feels his heart rate increase he will have a seizure.

“It’s like a whole new life for him,” said Gaige’s grandmother. “We’re so thankful.”

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