Our Approach to Pediatric Neurological Conditions
The Division of Pediatric Neurological Surgery at Children’s Hospital at Montefiore Einstein (CHAM) is an internationally recognized leader in the field of pediatric neurosurgery, providing state-of-the-art care to children with complex neurological conditions in a supportive environment designed to promote both patient and family wellbeing. Our multidisciplinary team of world-renowned specialists are thought leaders at the forefront of pediatric neurosurgical care, research and education, leading national and international neurosurgical societies. We’re ranked among the best children’s hospitals in the nation and in the top 1% of all hospitals in the nation for neurology and neurosurgery, according to U.S. News & World Report. We are also an international referral site for complex pediatric neurosurgical cases.
Our team includes highly specialized experts in pediatric neurosurgery who work together with specialists from our divisions of Craniofacial Surgery, Pediatric Surgery, Pediatric Neurology, Pediatric Hematology, Oncology and Cellular Therapy, and Pediatric Otolaryngology, among others, utilizing the latest and most advanced technology to deliver comprehensive and individualized, family-centered care for children to optimize neurological function and quality of life. We treat the full spectrum of pediatric neurological conditions, including congenital disorders (e.g., Chiari malformations); craniofacial disorders (e.g., craniosynostosis); functional disorders; vascular disorders; epilepsy; hydrocephalus; perinatal injuries, including brachial plexus injuries, spasticity and cerebral palsy hypertonia; spina bifida; tethered spinal cord; tumors of the brain spinal cord and peripheral nerves; and other conditions.
Unmatched Surgical Expertise for the Most Complex Conditions
Parents of children with problems affecting their brains, spinal cords and nerves turn to the Division of Neurosurgery at CHAM for unmatched expertise in the treatment of rare craniofacial anomalies and other congenital abnormalities, such as Chiari malformations and tethered spinal cords. Our pediatric neurosurgeons work together with colleagues in the Division of Pediatric Hematology, Oncology and Cellular Therapy at CHAM to help manage one of the largest patient populations of children with nervous system tumors in the New York region. Our division offers surgery for childhood epilepsy and cares for a large number of children with hydrocephalus and birth injuries, using both standard treatments and endoscopy. Our team is widely recognized for managing particularly challenging cases, deemed inoperable by other institutions.
Advanced Treatments
We diagnose and treat children using a multidisciplinary team approach that includes the latest and most advanced diagnostic and treatment techniques and technologies to facilitate precision care plans.
Our specialists utilize state-of-the-art imaging technology and have been involved in the development of computer-based technologies now commonly used throughout the world to guide surgery for children with nervous system disorders. As leaders in the management of craniofacial abnormalities, our team utilizes 3D modeling and intraoperative CT (computed tomography) scanning to understand a patient’s deformity and design and execute the correction plan surgically. We were the first to publish on advanced techniques of coupling pre-surgical reconstruction plans with intraoperative CT imaging of the skull. We have also achieved international recognition as a center of excellence in the management of conjoined twins as well as myelomeningocele.
Our team of experts utilizes the most advanced surgical approaches available today, including open, minimally invasive, robotically assisted and endoscopic surgery, multispecialty surgery, intraoperative neurophysiological monitoring, and computer-assisted surgery. Our continued work in the development of newly emerging techniques and technologies ensures that children undergoing neurosurgery at CHAM are offered access to leading-edge surgical techniques that minimize the risk of complications and maximize function and quality of life for each patient and their family.
Unlocking New Treatments
The depth and breadth of expertise within the Division of Neurosurgery spans the clinical spectrum of problems affecting children’s brains, spinal cords and nerves.
Our physicians are involved in investigations to better understand these problems and how best to manage them. In addition to the ongoing collection of information about the clinical outcomes of our patients, the division is involved in research projects about the treatment of tumors of the nervous system, the development of new imaging technology for understanding the clinical features of hydrocephalus and epilepsy, the utilization of 3D printing technology in the surgical correction of abnormally shaped skulls, and the use of neurosurgical techniques to manage abnormal muscle tone in chronically disabled children.
Our commitment to exploring better ways to manage the challenging neurological problems seen in young patients has improved outcomes, reduced the number of surgeries that children require and allowed ready access to innovative treatments at the leading-edge of pediatric neurosurgery.
Your Pediatric Neurological Surgery Center Team
Our multidisciplinary team of pediatric neurosurgery experts is at the forefront of pediatric care and the development of neurosurgical therapies. From prevention to treatment options, we will propose an individualized treatment plan that fits your child’s needs and lifestyle. Montefiore Einstein’s neurological surgery specialists are among the world’s leading surgeons and perform the most delicate and complex surgeries with overwhelmingly positive outcomes.
Get to know the world-class physicians and leadership that guide our Pediatric Neurological Surgery Center team.
Mandana Behbahani, MD
Andrew J. Kobets, MD
About Pediatric Neurological Surgery Center Conditions
Chiari Malformations
Chiari malformations (CM) are structural defects where the lower part of your brain presses on and through an opening in the base of the skull and cerebellum into the spinal canal. The cerebellum is the part of the brain that controls balance. Normally the cerebellum and parts of the brain stem sit above an opening in the skull (called the foramen magnum) that allows the spinal cord to pass through it. When part of the cerebellum extends below this opening and into the upper spinal canal, it is called a CM.
Craniosynostosis
Craniosynostosis is a skull deformity that occurs when the bones of the skull close together before the brain fully develops. The skull has fibers—called sutures—that connect parts of the skull and allow the brain to grow while it develops. Often, only one suture will close early. Premature fusing of the sutures results in a misshapen skull that cannot expand for the growing brain. This leads to increased pressure in the skull and impaired development of the brain.
Hydrocephalus
Hydrocephalus is a neurological disorder caused by an abnormal buildup of cerebrospinal fluid in the ventricles (cavities) deep within the brain. This excess fluid causes the ventricles to widen, putting harmful pressure on the brain's tissues. Hydrocephalus may be present at or shortly after birth, or may result over time from damage or injury.
Spina Bifida
Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD).
Spina bifida can happen anywhere along the spine if the neural tube does not close all the way. When the neural tube doesn’t close all the way, the backbone that protects the spinal cord doesn’t form and close as it should. This often results in damage to the spinal cord and nerves.
Spina bifida might cause physical and intellectual disabilities that range from mild to severe. The severity depends on:
- The size and location of the opening in the spine
- Whether part of the spinal cord and nerves are affected
Brain & Spinal Cord Tumors
A tumor is a mass of abnormal cells that either form into a new growth or were present as a mass at birth (congenital). Tumors occur when something goes wrong with genes that regulate cell growth, allowing cells to grow and divide out of control. Tumors can form anywhere in the body. Brain tumors form in the tissue inside the brain, which makes up the central nervous system (CNS). Spinal cord tumors form in the tissue inside the spinal cord, which is part of the central nervous system (CNS).
Depending on its type, a growing tumor may not cause any symptoms or can kill or displace healthy cells or disrupt their function. A tumor can move or press on sensitive tissue and block the flow of blood and other fluid, causing pain and inflammation. A tumor can also block the normal flow of activity in the brain or signaling to and from the brain. Some tumors don't cause any changes.
