Primary Office

Nemours Children's Hospital, Delaware Nemours Children's Hospital, Delaware 1600 Rockland Road Wilmington, DE 19803 Appointment: (800) 416-4441

Other Offices

What I'm Passionate About

My goals are to employ all the resources of medical science and my own personal experience to provide intelligent care to children with neurosurgical conditions, to advance the medical science of pediatric neurosurgery, and to treat patients and families with respect.

Education & Training

Fellowship

  • Pediatric Neurosurgery - The Hospital for Sick Children, 1987

Internship

  • Surgery - Hospital of The University of Pennsylvania, 1980

Residency

  • Neurology - Oregon Health and Sciences University, 1983
  • Neurosurgery - Duke University Medical Center, 1986

Medical/Dental School

  • MD - University of Pennsylvania School of Medicine, 1979

Board Certifications

  • American Board of Neurological Surgery

Awards & Recognition

  • 2016 Philadelphia Magazine's Top Doctors
  • 2015 Philadelphia Magazine's Top Doctors
  • 2014 Best Doctors in America
  • 2014 Philadelphia Magazine's Top Doctors
  • 2013 Best Doctors in America
  • 2011 Best Doctors in America
  • 2009 Anthony E Gallo Lectureship, Oregon Health Sciences University, Portland, Oregon
  • 1996 Department of Surgery Teaching Award Oregon Health Sciences University, Portland, Oregon

Insurance Accepted

  • Aetna Better Health PA Kids HMO
  • Aetna HMO
  • Aetna PPO/EPO/POS
  • Aetna PPO/POS/EPO
  • Amerihealth Caritas DE - PENNSYLVANIA SPECIALISTS ONLY
  • Amerihealth Caritas Delaware
  • Carefirst MD Community Health Plan Mcaid
  • Cigna & Great West HMO/POS/EPO
  • Cigna & Great West PPO
  • Cigna/Great West HMO EPO POS
  • Cigna/Great West PPO
  • Delaware First Health
  • Delaware Medicaid/Diamond State
  • Delaware Medicare
  • Devon Health Services
  • Fidelis Care NJ Medicaid HMO
  • First Health PPO
  • First Health/Affordable PPO
  • Geisinger Health Plan Commercial
  • Global Medical Managment DE/PA
  • Global Medical Mangment NJ
  • Health Partners Medicaid/Kidz Partner HMO
  • Highmark Blue Cross Blue Shield of Delaware
  • Highmark Blue Cross Blue Shield of Pennsylvania
  • Highmark Medicaid Health Options
  • Horizon Blue Cross Blue Shield of New Jersey
  • Independance Blue Cross/Amerihealth/Keystone Health Plan
  • Insurance Administrators of America
  • INTEGRA Administrative Group (ClaimsBridge)
  • Keystone First Medicaid HMO
  • Lifetrac Transplant
  • Maryland Medicaid
  • Multiplan PPO
  • New Jersey Medicaid
  • Pennsylvania Medicaid
  • Plan Vista/NPPN PPO
  • Preferred Healthcare PPO
  • Private Health Care Systems (PHCS)
  • Private Healthcare Systems (PHCS)
  • Qualcare HMO/POS/PPO
  • Star Healthcare Network
  • Three Rivers Provider Network
  • Tricare/Humana Military Health Services
  • United Healthcare of the Mid-Atlantic
  • UPMC MCAID/CHIP PA DE
  • UPMC Medicaid
  • US Family Health Plan
  • Wellpoint Maryland Medcaid

  • Brachial Plexus Birth Injury
  • Chiari Malformation
  • Hydrocephalus
  • Spina Bifida
  • Syringomyelia

Research Activities

My research activities include topics such as:

  • Epidemiology of pediatric neurosurgical conditions
  • Healthcare outcome disparities in pediatric neurosurgery
  • Quality measurement in the management of hydrocephalus

  • Tangential cranial gunshot wound in an infant in historical context: illustrative case; Journal of Neurosurgery: Case Lessons; (2022).

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  • A taxonomy of childhood pedal cyclist injuries from latent class analysis: associations with factors pertinent to prevention; Injury Epidemiology; (2022).

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  • Low-pressure CSF shunt malfunction without preceding lumbar puncture treated by epidural blood patch: report of 2 cases; Child's Nervous System; (2021).

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  • Racial disparities in mortality after severe traumatic brain injury in childhood: mediators identified by Oaxaca-Blinder decomposition of trauma registry data; Injury Epidemiology; (2021).

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  • Pediatrics; Operative neurosurgery (Hagerstown, Md.); (2019).

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  • Epidemiology of spinal injury in childhood and adolescence in the United States: 1997-2012; Journal of Neurosurgery: Pediatrics; (2018).

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  • Penetrating spinal injury in childhood: The influence of mechanism on outcome. An epidemiological study; Journal of Neurosurgery: Pediatrics; (2018).

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  • Principles of system design not realized for pediatric craniospinal trauma care in the United States; Journal of Neurosurgery: Pediatrics; (2018).

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  • The Preventable Shunt Revision Rate and the measurement of quality in pediatric hydrocephalus; Journal of Neurosurgery: Pediatrics; (2017).

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  • Response; Journal of Neurosurgery: Pediatrics; (2017).

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  • Giant hypothalamic hamartoma; Applied Radiology; (2017).

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  • Constitutional LZTR1 mutation presenting with a unilateral vestibular schwannoma in a teenager; Clinical Genetics; (2017).

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  • Macrocephaly in infancy: Benign enlargement of the subarachnoid spaces and subdural collections; Journal of Neurosurgery: Pediatrics; (2016).

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  • Adults with myelomeningocele and other forms of spinal dysraphism: Hospital care in the United States since the turn of the millennium; Journal of Neurosurgery: Spine; (2016).

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  • Response; Journal of Neurosurgery: Pediatrics; (2016).

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  • Pediatric Head Injury in the Delaware Trauma System: Toward Improved Calibration of Severity and Resource Utilization; Delaware medical journal; (2016).

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  • Beta hairpin peptide hydrogels as an injectable solid vehicle for neurotrophic growth factor delivery; Biomacromolecules; (2015).

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  • Spinal cord injury without radiographic abnormality and the chiari malformation: Controlled observations; Pediatric Neurosurgery; (2015).

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  • Response; Journal of Neurosurgery: Pediatrics; (2015).

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  • Pediatric spinal injury in the US: Epidemiology and disparities; Journal of Neurosurgery: Pediatrics; (2015).

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  • Incidental findings on brain and spine imaging in children; Pediatrics; (2015).

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  • Thirty-day outcomes of cerebrospinal fluid shunt surgery: Data from the National Surgical Quality Improvement Program-Pediatrics: Clinical article; Journal of Neurosurgery: Pediatrics; (2014).

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  • Quality measurement in the shunt treatment of hydrocephalus: Analysis and risk adjustment of the Revision Quotient: Clinical article; Journal of Neurosurgery: Pediatrics; (2014).

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  • Fracture of the anterior arch of atlas after minor trauma of the immature spine postlaminectomy; Pediatric Emergency Care; (2014).

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  • Quality measures for the management of hydrocephalus: Concepts, simulations, and preliminary field-testing: Clinical article; Journal of Neurosurgery: Pediatrics; (2013).

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  • Comments; Neurosurgery; (2013).

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  • Response; Journal of Neurosurgery: Pediatrics; (2012).

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  • Hospital care of childhood traumatic brain injury in the United States, 1997-2009: A neurosurgical perspective: Clinical article; Journal of Neurosurgery: Pediatrics; (2012).

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  • Cerebellar gliomatosis in a toddler: Case report of a challenging condition and review of the literature; Journal of Child Neurology; (2012).

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  • Conflict of interest; Journal of Neurosurgery; (2011).

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  • Acute VI nerve palsy in a 4 year-old girl with Chiari I malformation and pontomedullary extension of syringomyelia: Case report and review of the literature; European Journal of Paediatric Neurology; (2011).

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  • Intracranial suppuration complicating sinusitis among children: An epidemiological and clinical study - Clinical article; Journal of Neurosurgery: Pediatrics; (2011).

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  • Intracranial localisation of ictal urinary urge epileptogenic zone to the non-dominant temporal lobe; Epileptic Disorders; (2011).

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  • Developmental anatomy of the atlas and axis in childhood bycomputed tomography: Clinical article; Journal of Neurosurgery: Pediatrics; (2011).

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  • Prevention and management of positional skull deformities in infants; Pediatrics; (2011).

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  • "Never events" come to neurosurgery; Journal of Neurosurgery; (2010).

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  • Cervical spine clearance; Journal of Neurosurgery: Pediatrics; (2010).

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  • Treatment of myelomeningocele: A review of outcomes and continuing neurosurgical considerations among adults - A review; Journal of Neurosurgery: Pediatrics; (2010).

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  • Sagittal synostosis and ossified scalp hematoma: Cause or consequence? Report of 2 cases; Journal of Neurosurgery: Pediatrics; (2010).

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  • Posthemorrhagic ventricular dilation; Journal of Neurosurgery: Pediatrics; (2010).

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  • A multicenter study of factors influencing cerebrospinal fluid shunt survival in infants and children; Neurosurgery; (2009).

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  • Tethered cord release; Journal of Neurosurgery: Pediatrics; (2009).

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  • Neurosurgical education for pediatricians; Journal of Neurosurgery: Pediatrics; (2009).

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  • Jefferson fractures of the immature spine: Report of 3 cases; Journal of Neurosurgery: Pediatrics; (2009).

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  • Clinical diagnosis of ventriculoperitoneal shunt failure among children with hydrocephalus; Pediatric Emergency Care; (2008).

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  • Subdural hygroma associated with axillary cystic hygroma; Journal of Pediatric Neurology; (2008).

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  • Ultrasound guidance; Journal of Neurosurgery: Pediatrics; (2008).

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  • Surgical management of the Chiari malformation Type I - The way forward; Journal of Neurosurgery: Pediatrics; (2008).

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  • The section on neurological surgery of the American academy of pediatrics: Annual report 2006 to 2007; Journal of Neurosurgery: Pediatrics; (2008).

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  • Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus; Journal of Neurosurgery; (2007).

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  • Cervical spinal cord neurapraxia in the setting of Klippel-Feil anomaly: A diagnostic and therapeutic challenge; Spinal Cord; (2007).

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  • The section on neurological surgery of the American Academy of Pediatrics: Annual Report 2005 to 2006; Journal of Neurosurgery; (2007).

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  • Survival of shunts; Journal of Neurosurgery; (2007).

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  • Dorsal rhizotomy; Journal of Neurosurgery; (2006).

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  • Application of computer-assisted design in craniofacial reconstructive surgery using a commercial image guidance system: Technical note; Journal of Neurosurgery; (2006).

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  • Detected and overlooked cervical spine injury in comatose victims of trauma: Report from the Pennsylvania Trauma Outcomes Study; Journal of Neurosurgery: Spine; (2006).

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  • The Section on Neurological Surgery of the American Academy of Pediatrics Annual Report 2004-2005.; Journal of neurosurgery; (2006).

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  • Intrathecal baclofen overdose and withdrawal; Pediatric Emergency Care; (2006).

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  • Birth injuries of the brachial plexus; Clinics in Perinatology; (2005).

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  • Virtual and medical prototype assisted craniofacial reconstructive surgery; Virtual Modelling and Rapid Manufacturing - Advanced Research in Virtual and Rapid Prototyping; (2005).

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  • Progressive syringomyelia controlled by treatment of associated hydrocephalus in an infant with birth injury: Case report; Journal of Neurosurgery; (2005).

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  • Intramedullary spinal tumors; Textbook of Neuro-Oncology; (2005).

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  • Detected and overlooked cervical spine injury among comatose trauma patients: from the Pennsylvania Trauma Outcomes Study.; Neurosurgical focus; (2005).

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  • Intrathecal baclofen overdose followed by withdrawal: Clinical and EEG features; Pediatric Neurology; (2005).

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  • Pediatric neurosurgery; Pediatric Clinics of North America; (2004).

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  • Hydrocephalus; Pediatric Clinics of North America; (2004).

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  • Birth injuries of the brachial plexus; Pediatric Clinics of North America; (2004).

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  • A 2-year follow-up of outcomes following orthopedic surgery or selective dorsal rhizotomy in children with spastic diplegia; Journal of Pediatric Orthopaedics Part B; (2004).

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  • Recognizing neurosurgical conditions in the pediatrician's office; Pediatric Clinics of North America; (2004).

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  • Selective dorsal rhizotomy versus orthopedic surgery: A multidimensional assessment of outcome efficacy; Archives of Physical Medicine and Rehabilitation; (2004).

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  • Peritoneal Cerebrospinal Fluid Shunt Insertion; Journal of Neurosurgery; (2004).

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  • Skin hemangiomas and occult dysraphism; Journal of Neurosurgery; (2004).

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  • Unexpected findings on brain and spine imaging in children; Pediatric Clinics of North America; (2004).

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  • Syringomyelia complicating myelomeningocele: Review of the evidence; Journal of Neurosurgery; (2004).

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  • Spinal deformity after selective dorsal rhizotomy in ambulatory patients with cerebral palsy; Journal of Pediatric Orthopaedics; (2004).

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  • Pump implantation for intrathecal baclofen infusion after laparotomy for necrotizing enterocolitis; Pediatric Neurosurgery; (2003).

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  • Ultrasonographic screening in infants with isolated spinal strawberry nevi; Journal of Neurosurgery; (2003).

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  • A late result of an early operation for unilateral coronal synostosis; Pediatric Neurosurgery; (2003).

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  • Objective measurement of muscle strength in children with spastic diplegia after selective dorsal rhizotomy; Archives of Physical Medicine and Rehabilitation; (2002).

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  • Glutaric aciduria type 1 and nonaccidental head injury [1]; Pediatrics; (2002).

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  • Insertion of ventriculoperitoneal and ventriculovenous cerebrospinal fluid shunts; Techniques in Neurosurgery; (2001).

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  • Why is there CSF?; Pediatric Neurosurgery; (2001).

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  • Receiver-operating characteristic curves [4] (multiple letters); Journal of Neurosurgery; (2001).

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  • Monozygotic twins discordant for external hydrocephalus; Pediatric Neurosurgery; (2001).

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  • Relationship of cerebral perfusion pressure and survival in pediatric brain-injured patients; Journal of Trauma - Injury, Infection and Critical Care; (2000).

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  • Long-term follow-up data from the shunt design trial; Pediatric Neurosurgery; (2000).

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  • A hazard of combining the infratentorial supracerebellar and the cerebellomedullary fissure approaches: Cerebellar venous insufficiency; Pediatric Neurosurgery; (2000).

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  • The Chiari II malformation: Lesions discovered within the fourth ventricle; Pediatric Neurosurgery; (1999).

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  • Subdural empyema complicating cerebrospinal fluid shunt infection; Pediatric Neurosurgery; (1999).

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  • Chiari malformation associated with vitamin D-resistant rickets: Case report; Neurosurgery; (1998).

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  • A preadolescent with polydipsia and polyuria; Pediatric Neurosurgery; (1998).

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  • Spontaneous involution of a diencephalic astrocytoma; Pediatric Neurosurgery; (1998).

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  • Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus; Neurosurgery; (1998).

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  • Does gait continue to improve 2 years after selective dorsal rhizotomy?; Journal of Pediatric Orthopaedics; (1997).

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  • Developmental skills of children with spastic diplegia: Functional and qualitative changes after selective dorsal rhizotomy; Archives of Physical Medicine and Rehabilitation; (1997).

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  • Resection of fourth ventricle tumors without splitting the vermis: The cerebellomedullary fissure approach; Pediatric Neurosurgery; (1997).

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  • Shaving of the scalp may increase the rate of infection in csf shunt surgery; Pediatric Neurosurgery; (1997).

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  • Pumping the shunt revisited; Pediatric Neurosurgery; (1996).

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  • Hydrocephalus and epilepsy: An actuarial analysis; Neurosurgery; (1996).

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  • Gait changes in children with spastic diplegia after selective dorsal rhizotomy; Journal of Pediatric Orthopaedics; (1996).

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  • Tethered hindbrain: Case report; Journal of Neurosurgery; (1996).

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  • Assessment of upper-extremity function in children with spastic diplegia before and after selective dorsal rhizotomy; Developmental Medicine and Child Neurology; (1996).

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  • Craniofacial conodysplasia; Journal of Pediatric Orthopaedics; (1995).

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  • Cerebrospinal fluid shunt failure: Late is different from early; Pediatric Neurosurgery; (1995).

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  • Agenesis and dysgenesis of the sacrum: Neurosurgical implications; Pediatric Neurosurgery; (1995).

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  • Subgaleal hematoma: The need for increased awareness of risk; Journal of Family Practice; (1995).

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  • Peritoneal cerebrospinal fluid shunt insertion: A technique for protection of the abdominal catheter. Technical note; Journal of Neurosurgery; (1995).

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  • Isolated spinal cord injury as a presentation of child abuse; Pediatrics; (1995).

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  • Sacral agenesis associated with spinal cord syrinx; Pediatric Neurosurgery; (1994).

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  • Preoperative diagnostic evaluation of children with Cushing's syndrome; Journal of Pediatric Surgery; (1994).

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  • How effective are ventriculopleural shunts?; Pediatric Neurosurgery; (1994).

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  • Hair and neurosurgery; Neurosurgery; (1994).

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  • Cerebrospinal fluid shunt infection by Neisseria sicca; Pediatric Neurosurgery; (1994).

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  • An infant in a car seat on a washing machine: Epidural hematoma; Pediatrics; (1994).

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  • The frequency of intradural conjoined lumbosacral dorsal nerve roots found during selective dorsal rhizotomy; Neurosurgery; (1994).

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  • Management and outcome of low-grade astrocytomas of the midline in children: A retrospective review; Neurosurgery; (1993).

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  • Birth trauma and intracranial aneurysm [2]; Journal of Neurosurgery; (1993).

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  • A search for determinants of cerebrospinal fluid shunt survival: Retrospective analysis of a 14-year institutional experience; Pediatric Neurosurgery; (1993).

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  • Physical examination of patients with cerebrospinal fluid shunts: Is there useful information in pumping the shunt?; Pediatrics; (1992).

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  • Intracranial arterial aneurysm due to birth trauma. Case report; Journal of Neurosurgery; (1992).

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  • Neurosurgical management of birth injuries of the brachial plexus.; Neurosurgery clinics of North America; (1991).

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  • Mechanical complications in shunts; Pediatric Neurosurgery; (1991).

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  • Management of axial low-grade astrocytomas in childhood; International Pediatrics; (1991).

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  • Letter to the editor (I); Military Medicine; (1991).

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  • Brachial plexus birth injury; Western Journal of Medicine; (1990).

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  • Reduction cranioplasty for craniocerebral disproportion in infancy: Indications and technique; Pediatric Neurosurgery; (1990).

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  • Trauma case for diagnosis: Atlantooccipital dislocation; Military Medicine; (1989).

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  • Multiple subpial transection in treatment of focal epilepsy.; Journal of Neurosurgery; (1989).

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  • Correction of the prominent occiput in Beckwith-Wiedemann syndrome; Pediatric Neuroscience; (1989).

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  • Cor pulmonale: a lethal complication of ventriculoatrial CSF diversion; Child's Nervous System; (1989).

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  • Preliminary experiences with brachial plexus exploration in childen: Birth injury and vehicular trauma; Neurosurgery; (1988).

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  • Chronic Focal Encephalitis (Rasmussen Syndrome): Six Cases; Epilepsia; (1988).

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  • Papillary meningioma involving the oculomotor nerve in an infant. Case report; Journal of Neurosurgery; (1986).

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  • Limitation of brain stem auditory evoked potentials for intraoperative monitoring during a posterior fossa operation: Case report and technical note; Neurosurgery; (1985).

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  • Treatment of tic douloureux and hemifacial spasm by posterior fossa exploration: Therapeutic implications of various neurovascular relationships; Neurosurgery; (1984).

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  • Microvascular decompression for tic douloureux.; Neurosurgery; (1984).

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  • Massive intracerebral hemorrhage complicating cardiac catheterization with ergonovine administration; Stroke; (1984).

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  • High dose barbiturate therapy in neurosurgery and intensive care; Neurosurgery; (1984).

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  • Pineal region meningioma: Report of two cases and literature review; Neurosurgery; (1983).

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  • Glioblastoma multiforme after radiotherapy for acromegaly; Neurosurgery; (1983).

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