Pediatric Care at UW Gamma Knife Center at Harborview

Some brain lesions in pediatric patients are suitable for the Gamma Knife. For our young patients, general anesthesia is used and the hospital stay is generally overnight in our pediatric care unit. The UW Gamma Knife Center at Harborview Medical Center treats nearly 500 children a year and we have a close relationship with Children's Regional Hospital and Medical Center. We have a pediatric intensivist and pediatric nurse educator on staff as well as recreational therapists to make the child's stay as comfortable as possible.

Partnering with Children's Hospital and Regional Medical Center

Dr. Ellenbogen is the Chairman of UW Medicine Neurological Surgery at the University of Washington School of Medicine, the Theodore S. Roberts Endowed Chair in Pediatric Neurosurgery, Chief of Neurological Surgery at Harborview Medical Center and Adjunct Professor of Radiology.

Dr. Richard Ellenbogen is also the Chair for Children’s Hospital and Regional Medical Center. This enables our team of experts to work closely with Children's Hospital to provide the most comprehensive care for children with diseases and disorders of the nervous system and its supporting structures. 

Children's Hospital and Regional Medical Center (CHRMC) provides seven specialty programs all involving multidisciplinary care for children. 

1. Pediatric Neuro-Oncology Program: This comprehensive program is centered around the pediatric neurosurgery, hematology-oncology, radiation oncology and neurology services and offers the most up-to-date treatments available. The research arm includes National Institutes of Health (NIH) and other extramural-supported efforts for original studies on the molecular aspects of pediatric tumors. Research is performed at the Children's Hospital and Regional Medical Center, Fred Hutchinson Research Center, and the University of Washington Research Laboratories. The clinical service at Children's Hospital is part of the Cancer Care Group consortium of hematology-oncology protocols and is directed by Dr. J. Russell Geyer. The broad and aggressive pediatric neurosurgery effort includes skull base approaches to tumors, minimally invasive endoscopic neurosurgery, frameless stereotaxis and intra-operative adjuvant therapy; all are performed with capabilities for intra-operative electrophysiological monitoring.
   
   
2. Craniofacial Program: This internationally renowned program is guided by specialists in pediatric neurosurgery, craniofacial plastic surgery, pediatrics, genetics, oral and maxillofacial surgery, ophthalmology and otolaryngology. This extensive, multidisciplinary clinic cares for patients from all over the country with cranio-synostosis, syndromal craniofacial anomalies, plagiocephaly from positional molding, facial tumors, craniofacial trauma and cleft-lip and palate. The research efforts are centered around understanding suture and bone biology at the molecular and cellular level. Dr. Joseph S. Gruss directs these clinics which offer innovative treatments for these disorders. 
   
   
3. Congenital Birth Defects Clinic: This pioneering multidisciplinary clinic provides long term care for children with hydrocephalus of all etiologies, neural tube defects, spina bifida, tethered spinal cord, syringomyelia, lipomeningomyelocle and other less common abnormalities of development. A wide array of pediatric subspecialty services participate in this clinic, including pediatric neurology, urology, orthopedics, general surgery, neurogenetics, neurological surgery, and other allied health care providers. Neurosurgical areas of interest include treatments for hydrocephalus, endoscopic ventricular surgery, Chiari malformations and syringomyelia, CSF flow physiology and utilization of advanced imaging techniques. 
   
   
4. Comprehensive Epilepsy Program: This surgical epilepsy program is part of the University of Washington's comprehensive epilepsy program. Epileptologists, neuro-psychologists, social workers and neurosurgeons make up the management team. Awake intra-operative mapping, intra-operative electrocorticography and pre-resection invasive monitoring are used. A broad range of surgical expertise is offered, such as hemispherectomy, corpus callosotomy, vagal stimulation, temporal lobectomy, extra-temporal resection and subpial resection. Individual patient cases are reviewed prior to surgery at a weekly conference attended by surgeons, neurologists, and neuro-psychologists from the University of Washington Medical Center (UWMC), Harborview Medical Center (HMC) and Children's Hospital & Regional Medical Center (CHRMC). The Surgical Epilepsy Program is directed by Dr. Jeffrey Ojemann at CHRMC.
   
   
5. Pediatric Neurovascular Team: This team of neurosurgeons, neuro-interventional radiologists and radiation therapists treat the entire spectrum of cerebrovascular diseases of the brain and spine. The pediatric diseases treated include arteriovenous malformations (AVM), cavernous malformations, spinal malformations, Moya-Moya disease and aneurysms. The multidisciplinary team involves neurosurgeons, Drs. David W. Newell and Richard G. Ellenbogen, interventional neuro-radiologists, Drs. Joseph M. Eskridge and Douglas Haynor, and a neuro-radiologist, Dr. Dennis Shaw. This team utilizes innovative, state-of-the-art technologies  to evaluate and treat vascular disorders. Radiosurgery capability includes Gamma Knife® treatment at Harborview Medical Center and LINAC Scalpel® at UW Medical Center, with functional MRI used for cortical localization and mapping. Interventional surgical capabilities include AVM resection preceded by embolization and cortical mapping, cerebrovascular bypass, and revascularization procedures. Similar approaches are utilized in the treatment of cerebral aneurysms and Moya-Moya disease. 
   
   
6. Complex Spine Service: Congenital and acquired deformities of the spine are treated by a team of neurosurgeons, Drs. Richard G. Ellenbogen, orthopedic spine surgeons, Drs. Mohammed Diab, Kit Song, and rehabilitation medicine specialists. Spinal cord tumors, complex congenital deformities, spondylolisthesis/spondylolysis, fractures and deformities are repaired with the most modern spinal instrumentation techniques and intra-operative monitoring. Postoperative rehabilitation for those traumatic injuries is undertaken at CHRMC’s rehabilitative medicine unit, directed by Dr. Kenneth Jaffe. 
   
   
7. Spasticity Management Team: This team consists of neurosurgeons, neurologists, orthopedic surgeons, development pediatricians, physical and rehabilitation medicine physicians and physical therapists. Selective dorsal rhizotomy, baclofen pumps, botulism toxin injections and tendon releases are all part of the armamentarium to treat the wide spectrum of children with spasticity. This multidisciplinary clinic is continuously analyzing outcomes and improving methods for treating these children.

To learn more about these specialties, please visit the Children's Hospital and Regional Medical Center Neurosurgery Web pages.