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Neurosurgery Team

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The board-certified neurosurgical team with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, is led by Thomas M. Moriarty, M.D., Ph.D., a recognized leader in the field with extensive experience and specialized training. Our physicians in Louisville and Southern Indiana have the sophisticated tools and skills to give you and your child a precise diagnosis and treatment plan for craniosynostosis that minimizes risk, so your child can get back to being a kid again.

What is Craniosynostosis?

A newborn’s skull consists of several plates of bone that fuse together over time. When two or more of these plates fuse together before they are supposed to, they can cause the baby’s head to become misshapen. It’s not clear why craniosynostosis happens. It may be an inherited trait in some families. However, studies have not concluded why it occurs.

Will Craniosynostosis Affect My Child’s Development?

In some cases, craniosynostosis can lead to developmental delays and cognitive issues, but you should not assume the worst. It all depends on a variety of factors, including when the condition was diagnosed, how many plates are involved and whether any intracranial pressure occurred. The specialists at Norton Children’s Hospital are experienced in treating craniosynostosis in infants and children. They are the best people to talk to about potential long-term effects.

Sagittal Craniosynostosis and Other Types

Types of craniosynostosis are named for which skull plates are affected. Each type results in a different misshapen look to the head. Sagittal craniosynostosis is the most common of four types. It results in the head growing long and narrow, because it’s caused by the fusion of the line (suture) that runs along the top of the baby’s skull. This can cause the baby’s skull to appear boat-shaped.

Metopic synostosis is the fusion of the metopic suture, which runs from the top of the head down the middle of the forehead, toward the nose. The condition causes:

  • A forehead shaped like a triangle, called trigonocephaly
  • Eyes that are closer together than usual if the lower suture near the eyes is fused

Coronal synostosis is the premature fusion of one of the coronal sutures, which extend from ear to ear over the top of the head. Characteristics include:

  • Fusion of either the right or left side
  • The forehead and brow look like they are pushed back
  • The eye on the affected side has a different shape than the eye on the unaffected side

Bicoronal synostosis results when both coronal sutures fuse prematurely. Characteristics include:

  • A tall, flattened forehead and wide-shaped head. The fusion keeps the entire forehead from growing in a forward direction.

Regardless of the type, craniosynostosis can be treated.

Craniosynostosis Treatment

Unless it is a mild case, craniosynostosis is corrected with surgery. The multidisciplinary team of physicians in our craniofacial program, including neurosurgeons, plastic surgeons and ear, nose and throat physicians, work together to plan the best procedure to treat your child’s craniosynostosis. If detected early, the fused sutures can sometimes be released using limited or smaller incisions, called an endoscope.

If craniosynostosis is diagnosed later or is more advanced, it can be repaired with an open procedure in which the bone is expanded with absorbable plates. In some cases, the craniofacial team will elect to release the suture and place bone-expanding devices that penetrate through the skin until the expansion is complete.

Regular monitoring may be required. The experienced pediatric surgeons and physicians with the craniofacial program will be there every step of the way.

Why Norton Children’s Neuroscience Institute?

  • The Norton Children’s Hospital Comprehensive Epilepsy Center is a Level 4 epilepsy center, the highest rating available from the National Association of Epilepsy Centers. Norton Children’s Hospital has held this designation since 2013.
  • We are the first in Kentucky and among the first in the nation to use neurostimulation in a pediatric patient.
  • Regional neurology care is available for children across Kentucky and Southern Indiana. We travel to clinics in Bowling Green, Campbellsville, Corbin, Elizabethtown, Frankfort, Owensboro and Paducah, Kentucky; and Evansville, Indiana. We also perform a number of telemedicine visits each week.
  • The specialists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, use state-of-the-art technology to treat epilepsy, uncontrollable seizures and deep brain tumors in children who, in the past, would not be candidates for surgery, including:
    • Visualase: Technology that allows neurosurgeons to perform MRI-guided laser ablation surgery. Fewer than two dozen pediatric hospitals in the U.S. offer this technology.
    • Surgical Theater: Virtual reality technology that creates an immersive 3D view of a patient’s brain, allowing neurosurgeons, the patient and family to see inside the skull and brain to get a greater understanding of the condition and impact of potential procedures. Norton Children’s Hospital is the first hospital in the region to use this technology.
  • We offer dedicated multidisciplinary clinics for brain tumors, traumatic brain injuries, spina bifida, craniofacial injuries and disorders, epilepsy, muscular dystrophy, spasticity, headache/migraine, autism and neurocutaneous disorders.
  • Our multidisciplinary craniofacial program was the first established in the Midwest.
  • We offer a neurogenetics clinic to evaluate and treat children with neurogenetic syndromes.
  • We have a neuropsychology program that specializes in the evaluation of children and teens with a variety of neurological, neurodevelopmental and medical conditions, including brain tumors and epilepsy.
  • Outpatient neurology facilities in downtown Louisville are equipped with in-office electroencephalography (EEG) capabilities and laboratory services in the same building, creating a streamlined, family-centered environment.
  • We offer the region’s first clinic to treat children with immune-mediated neurological disorders.

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