Neurosurgery
The Acute Adult Neurosurgical Service is provided at the Vancouver General Hospital with a total census of 61 beds, including ten special care unit beds.
Comprehensive services are provided for all neurosurgical illnesses, to include brain and spinal cord tumors, hemorrhages, traumatic injuries, plus some degenerative conditions of the spine and brain.
One of a kind provincial service is offered in interventional treatment of strokes, surgery for epilepsy, surgical management of complex brain and spinal disorders, skull base surgery, brachial plexus reconstruction, stereotactic radiosurgery (in conjunction with British Columbia Cancer Agency {BCCA}), functional neurosurgery especially for the relief of pain, spasticity, and movement disorders such as Parkinsonism. Expertise is provided in major peripheral nerve reconstruction and multi-system trauma.
Over 1,800 in-patients per year are treated.
The Division of Pediatric Neurosurgery at British Columbia's Children's Hospital (BCCH) is the major referral centre for pediatric neurosurgical conditions in the province of British Columbia. The Division has established itself as one of the foremost pediatric neurosurgical units in Canada and is acclaimed internationally as a leader in pediatric neurosurgery. The Division comprises three full-time pediatric neurosurgeons: namely, Dr. Paul Steinbok who is head of the division, Dr. D. Douglas Cochrane and Dr. Ash Singhal. All three neurosurgeons are fully trained in pediatric neurosurgery and have limited their practices to the care of children with pediatric neurosurgical conditions.
The Division of Pediatric Neurosurgery is located at B.C. Children's Hospital, a part of Children's and Women's Health Centre. This is a tertiary care children's hospital with the full range of support services and the most modern equipment available for the management of neurosurgical disorders in children. The pediatric neurosurgeons are supported by a team of pediatric neurologists, intensivists, pediatric neuro-radiologists, pediatric neuro-pathologists, pediatric electrophysiologists and nurses, physiotherapists occupational therapists and social workers specifically trained in the management of neurological diseases in children. There are a number of well-established, multidisciplinary programs including a spina bifida program, spasticity and motor disorders program, an epilepsy surgery program, a neuro-oncology program, and cranio-facial program.
The Division performs approximately 300 neurosurgical operations yearly, and addresses the full range of neurosurgical conditions in children. These include surgeries for brain and spinal tumors, Chiari malformations, Moya Moya disease, syringomyelia, craniosynostosis, hydrocephalus, spina bifida, epilepsy, head injuries and cerebral palsy, among others. The neurosurgeons are experienced with neuroendoscopic and image guided neurosurgery.
The neurosurgeons at B.C. Children's Hospital have developed a team approach to the management of patients. Difficult clinical cases are routinely discussed among the three neurosurgeons and are often discussed as part of a multidisciplinary conference. All oncology cases, for example, are discussed at a multidisciplinary conference that includes not only neurosurgeons, but oncologists, neuro-oncologists, radiation oncologists, neuro-pathologists and radiologists. A similar approach is used to guide the management of patients with complex congenital malformations of the spinal cord. In order to develop the best expertise to ensure optimal management of complex conditions, particularly those that are less common, individual neurosurgeons have developed special expertise in the treatment of specific disorders. For example, Dr. Steinbok offers expertise to patients with craniopharyngioma, epilepsy, cerebral palsy, and moya moya disease; Dr. Cochrane congenital malformations of the fetus, complex spina bifida patients and pineal region tumors; and Dr. Singhal, expertise for those needing epilepsy surgery and adults with spina bifida.
The Division of Pediatric Neurosurgery has an ongoing quality assurance program, with regular assessments of complications, mortalities and outcomes. Our Division has consistently had among the shortest postoperative stays in Canada for a variety of neurosurgical conditions, including major craniotomies and shunt procedures, attesting to the low rate of postoperative complications. We also have one of the lowest rates of pediatric neurosurgical operations per unit population in North America, and this in part reflects the careful thoughtful approach of the neurosurgeons to the management of neurosurgical conditions and the ability of the neurosurgical team to achieve enduring results. We have achieved the lowest rates of blood transfusion in the world for open procedures to correct various types of craniosynostosis (see cranio-facial program).
The Division of Pediatric Neurosurgery is part of the Division of Neurosurgery at the University of British Columbia. The neurosurgeons have a major role in the education of medical students and residents in the Neurosurgical training program at UBC. Residents spend 6 months in one of their senior years at BCCH under the supervision of the pediatric neurosurgeons. In addition to residency training, the Division provides a 1 year fellowship for fully trained neurosurgeons, who wish special additional training in pediatric neurosurgery. This fellowship has been accredited by the Accreditation Council for Pediatric Neurosurgery in the United States of America. Up to this time, the Division has trained fellows and students from North America, Sweden, Brazil and Northern Ireland.
Both adult and pediatric services work in close alliance with neurologists, neuroradiologists, neuropathologists, neuro-oncologists, and a multi-disciplinary team of paramedical personnel. These latter include expert nurses, occupational therapists, physiotherapists, speech therapists, social workers, clinical instructors and clinical specialists, among others.
Regional rehabilitational facilities are provided by G. F. Strong Rehabilitation Centre (adults) and Sunnyhill Hospital (pediatric).
Dr. Ryojo Akagami - Director of Postgraduate Education
Program Assistant Sachiyo Kaneko
Dr. Thomas Zwimpfer - Director of Undergraduate Education
last revised: 2008-September-9