Dr. Hertzler with Neurosurgery patient

Pediatric Neurosurgery

Our neurosurgeons perform intricate procedures for complex pediatric brain and spine conditions.

Nobody wants to need a pediatric neurosurgeon. But if you do, you need a fellowship-trained pediatric physician with experience in complex neurological conditions and the unique ways to treat them in children.

We specialize in surgical treatments for unborn babies, infants, children and adolescents with conditions affecting their brain and spine. Our pediatric neurosurgery team uses leading-edge technology for the safest, most accurate approach to every procedure. We care for your whole family to help you through this stressful and frightening time.

Types of Pediatric Neurosurgery by Condition

If your child has a neurological condition involving a specific area of their brain, pediatric brain surgery may be a cure. It may also slow the disease process, help reduce symptoms or improve daily function. We have specific protocols for each neurosurgical procedure.

Craniofacial conditions

Our neurosurgeons can correct or minimize mild to severe deformities that affect a child’s skull. Examples include skull fractures and craniosynostosis

Epilepsy

In some children with , a specific area of the brain causes seizures. Surgical interventions can cure the condition or reduce the number or intensity of seizures. We may recommend cutting away the brain tissue that’s causing seizures or using a laser to destroy it.

Another procedure for epilepsy is vagus nerve stimulation. We implant a device under the skin in the left chest and connect it to the vagus nerve in the neck. The device sends mild electrical impulses through the nerve. The impulses can reduce the abnormal electrical signals responsible for seizures. 

Hydrocephalus

This condition is caused by abnormal fluid buildup deep within the brain in cavities called ventricles. This fluid buildup puts harmful pressure on brain tissue. Surgical intervention can help control symptoms, reduce pressure and protect the brain. 

One method is to place a drainage system under your child’s scalp. A tube called a shunt or catheter takes the fluid away from the brain and into the belly, where it can be naturally absorbed. Examples include endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VP shunt). A drainage system may have to stay in place for life and may require future surgeries. 

Another surgical option for hydrocephalus involves creating a small hole at the base of the brain. This option gives excess fluid a way to escape the brain. 

Neurocutaneous disorders

Neurocutaneous disorders are rare, genetic disorders that are present at birth. They can cause tumors to grow on the brain, spinal cord, organs, skin and bones. We have a multispecialty clinic for children with neurocutaneous disorders such as tuberous sclerosis and neurofibromatosis. In addition to neurosurgeons, the team may include neurologists, hematologists/oncologists, cardiologists and nephrologists as needed.

Spasticity and cerebral palsy

We offer medical and surgical treatments for spasticity that’s present at birth (congenital) and occurs later in life (acquired) through our Spasticity Clinic. They include:  

  • Baclofen pump: Baclofen is a muscle relaxant to treat spasticity. A surgeon places a small pump under the skin of the abdomen. A thin tube connects the pump to the spine, where the medicine is delivered. A pump can make medication more effective at a lower dose and reduce sleepiness as a side effect. The pump must be refilled every few months and replaced every five to seven years.  
  • Selective dorsal rhizotomy: This minimally invasive procedure cuts away some sensory nerve fibers in the spine. It can permanently reduce leg spasticity, often improving independent walking. 
Spina bifida and open neural tube defects

The neural tube is a structure that forms the early brain and spine in a baby as it grows in the womb. An open neural tube defect is a problem with how the brain, spinal cord or spine forms before birth. Spina bifida is the most common type of neural tube defect.

If your obstetrician or neonatal neurologist identifies this type of defect in your unborn baby, surgery before birth may help. We can repair some of these defects or reduce fluid on your baby’s brain (hydrocephalus) by going through the uterus. This surgery can improve outcomes after your baby is born. Our specialists can also repair neural tube defects and treat hydrocephalus after birth. We follow children throughout their lives at our Spina Bifida Clinic. 

Brain and spinal cord tumors

Surgery for a brain or spine tumor is often curative. It usually involves a craniotomy, which temporarily removes part of the skull to expose the brain for the procedure. Once we have access to the brain, we can cut out part or all of the tumor. We may also use laser ablation to target and destroy tumor tissue. Then the section of skull is put back into place. This less invasive option is available for some types of tumors.

Chiari malformation

A Chiari malformation occurs when part of your child’s brain tissue extends into their spinal canal. It’s caused when the lower back part of the skull is too small or misshapen and presses on brain tissue. Surgery can be curative or dramatically reduce symptoms, including headaches, balance problems, choking and gagging. 

Brain Tumor Experts Cured Joey at Joe DiMaggio Children's Hospital

Brain Tumor Experts Cured Joey at Joe DiMaggio Children's Hospital

Pediatric Neurosurgery: Why Choose Joe DiMaggio Children's Hospital? 

When you bring your child to Joe DiMaggio Children’s Hospital for neurosurgery, you’ll find:

  • Experienced specialists: We have a team of board certified, fellowship trained pediatric neurosurgeons. They have extensive training and experience performing these complex procedures, specifically in children.
  • Multidisciplinary approach: Our neurosurgeons are part of a multidisciplinary team of specialists who meet regularly to discuss your child’s treatment. This team approach leads to more convenient, coordinated, comprehensive care. Your care team includes your neurosurgeon and a neurologist who specializes in your child’s condition. The team also includes anesthesiologists, who control pain, and palliative care specialists, who help manage symptoms. Physical, occupational and speech therapists help your child regain function after surgery.
  • Advanced technology: For conditions related to the brain, we use state-of-the-art imaging technology called intraoperative MRI to accurately target the precise area of the brain involved and protect healthy tissue. We use neuromonitoring to check your child’s neurological status continuously to ensure that functional areas of the brain are still working well. 
  • Family-centered care: Having a child undergo neurosurgery can be a stressful and overwhelming experience for the entire family. We take time to listen to your concerns, answer your questions and offer support in any way we can. 
  • Welcoming environment: Our child life specialists create a welcoming environment for children and families so that the hospital experience is less scary. We have amenities and family areas to make your time here as comfortable and soothing as possible. You’re welcome to stay with your child as much as you’d like. We also offer an on-campus Conine Clubhouse as a special home away from home while your child is in the hospital. 
Meet Dr. Dean Hertzler - Chief, Pediatric Neurosurgery Program

Meet Dr. Dean Hertzler - Chief, Pediatric Neurosurgery Program

Dean Hertzler, MD, Pediatric Neurosurgeon, performs the delicate and complicated brain surgeries.

Driven to enter the medical field after his brother became sick with cancer, Dr. Hertzler considers it a privilege to lead children and families from the vulnerability of diagnosis, through treatment and to a restored life.
Moments that Count – Ethan’s Brain Aneurysm Story

Moments that Count – Ethan’s Brain Aneurysm Story

Watch to see how our neurology team and a Memorial brain surgeon helped Ethan and his family in the moments that count.
Routine Eye Exam Revealed Large Tumor In 6-year-old's Gracie's Brain.

Routine Eye Exam Revealed Large Tumor In 6-year-old's Gracie's Brain.

Gracie's parents took her to what they thought was just a regular eye examination.

Moments later, she was at Joe DiMaggio Children's Hospital diagnosed with a tumor.

Dr. Hertzler managed to get most of the tumor located on the back of Gracie's skull.

Gracie has made significant progress since her surgery, and her parents feel the eye exam saved her life.
Kyle’s Epilepsy Neurosurgery Story

Kyle’s Epilepsy Neurosurgery Story

Kyle’s mom says he’s doing fabulous after neurosurgery at Joe DiMaggio Children’s Hospital. See how our specialists in children’s epilepsy and neurosurgery were able bring Kyle’s intractable epilepsy seizures under control.

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