Congenital abnormalities / Spina Bifida / Hydrocephalus
Paediatric neurosurgeons deal with a wide variety of congenital abnormalities such as hydrocephalus (water on the brain), craniofacial abnormalities and spina bifida. Fortunately spina bifida has become a rarity because of the results or research into the use of folate and antenatal screening. Hydrocephalus remains a common problem and is an excellent example of the benefits of practical research. The treatment most commonly used today, a shunt containing a valve to regulate the amount of spinal fluid draining away, was developed by John Holter, a technician in a machine shop, when he had a child with hydrocephalus in 1955.
Neuroimaging, neurosurgical instruments, microscopes, frameless stereotaxy etc.
It is now possible for us to see inside the brain using a magnetic field which sounds like something from Star Trek but is being used as part of our everyday management of neurosurgical patients. MRI is a prime example of the value of clinical research. The principles of MRI were known in 1945 and won the Nobel Prize for Bloch and Purcell, but the clinical use of MRI only began in the 1980’s. This required the input of physics, computer technology and radiology, as well as neurology/neurosurgery. Neurosurgeons have taken this even further to develop frameless stereotaxy which allow us to see exactly where we are in the brain or spine on a computer screen, similar to the latest computer navigation systems installed in cars.
