MDNews - Long Island

WHEN TO GET A CT SCAN "Headache plus" — a headache plus vom- iting, especia lly projectile vomiting, or recurring headaches that intensify over time — is the classic indicator for having a CT scan. Other indicators include neck pa in, backsliding from developmenta l mi lestones, sudden impa ired v ision, facia l drooping, a rm or leg wea kness, a nd even, potentia l ly, sudden weight loss. A mong infa nts, hydrocepha lus, measured by a n enla rged head circum- ference, is the key indicator. These s y mptom s va r y to a deg ree a mong different age groups, especia lly b et we en i n fa nt s , pre s cho oler s a nd teenagers. To illustrate different pre- sentations, Dr. Gra nt refers to severa l cases from his six years at NSPC. These exa mples a lso demonstrate how bra in tumors or ma lformations a re detected a nd treated. PRENATAL INDICATORS Some neurolog ica l problems a re found even before a baby is born, underscoring the importance of prenata l ultrasounds. Dr. Gra nt dia g nosed one infa nt w it h massive hydrocepha lus in utero, which was later found to be caused by a seri- ous congen it a l bra i n ma lfor mation . He successfully operated on the infa nt a f ter she was born. T h e m a j o r i t y o f w o m e n h a v e u ltra sounds, most frequent ly occur- r i n g at 2 0 we ek s i nt o a preg n a nc y. W hen u ltra sounds uncover a serious neu r olo g ic a l pr oblem — whet her a m a l f o r m a t i o n , a t u m o r o r i s s u e , such a s spi na bi f ida or hyd rocepha- lus — Dr. Gra nt urges pa rents to see a neurosurgeon who ca n provide reliable i n for mat ion about t reat ment s a nd / or inter ventions. PRESENTATION IN INFANTS For babies ages 0 to 2, the primar y indi- cator of a bra in tumor or ma lformation is head circumference. Irritability ca n a lso be a factor, pa r ticula rly if it gets worse, a nd babies will sometimes pull at their ea rs because of it . Projecti le vomiting, especia lly in the morning,as well as fa lling shor t of milestones is a n additiona l wa rning sig n. D r. G r a nt r e c a l l s a not her i n f a nt patient, who was born prematurely and spent time in the NICU. A f ter she went home, her pediatrician noticed that her head circumference was getting la rger, but d id n't see a ny ot her concer n i n g hea lth issues. "If a physicia n hasn't measured the head circumference of a baby, then he or she hasn't fully exa mined the child," Meet the Neurosurgeon: John A. Grant, MD, FACS, BCh, MB DR. GR ANT RECEIVED his medical degree from the Medical School of the Royal College of Surgeons in Ireland, where he was an Arthur Jacob Scholar. He completed general surgery internships in Dublin and at Johns Hopkins Hospital. He also completed his neurosurgery residency at The Neurological Institute of New York at Columbia University. Dr. Grant's experience as a resident solidified his interest to continue in pediatric neurosurgery. After Columbia, Dr. Grant spent 11 years at Children's Memorial Hospital in Chicago. Dr. Grant has been with Neurological Surgery, P.C. in Mineola for the past six years. Prior to his time at NSPC, Dr. Grant taught and served as chair of the Department of Neurosurgery at the University of Kansas for nine years. He regularly visits Haiti, where he cares for children with hydrocephalus and other congenital malformations. He has written extensively about pediatric and congenital neurosurgery, as well as the history of neurosurgery and head trauma and has been a member of the editorial board of the peer-reviewed journal Pediatric Neurosurgery since 2006. Dr. Grant is a member of The American Society of Pediatric Neurosurgeons, the European Society for Pediatric Neurosurgery, the International Society for Pediatric Neurosurgery, the American Association of Neurological Surgeons, the Congress of Neurological Surgeons and the Nassau County Medical Society. Dr. Grant joins a young patient and her family six months after treatment for a post fossa abscess. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 018 0 7

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