Pediatric Conditions and Treatment A Visit to the Pediatric Neurosurgeon: What to Expect

Bethany: The process varies a bit based on why your child is seeing us, but in general there are a few things you can expect.

1. First, we will get a referral from your pediatrician which gives us information about why you need to see our team as well as information about your child's medical history. The referral also helps our team figure out how quickly your child needs to be seen.
   
   At Connecticut Children's, our neurosurgery team recognizes the importance of timely care when urgent treatment is needed, and we make every effort to ensure patients are seen as quickly as possible.
   
2. We'll ask you to bring certain things like:
   • Any relevant test results, such as MRI or CT scans
   • A list of any medicines your child takes
   
3. When you get here, we'll check your child's height, weight, head circumference if they are less than 2 years old, and other appropriate vital signs like blood pressure and temperature. Then you will meet with the neurosurgeon or neurosurgery nurse practitioner, like me.
   We will ask about your child's symptoms and history with questions like:
   • When did the symptoms start?
   • Have they gotten better or worse?
   • What tests have they had done and why were they obtained?
   • We will also likely ask about your child's development and if they are meeting appropriate milestones or if you or your pediatrician has concerns.
   
4. Then, we'll do a physical exam. With children, we can often gain a lot of information by observing them during our visit and how they interact with you, us, and their environment. We may also check how your child walks, moves, or responds to touch. We may test your child's balance, reflexes, or strength.
   
5. If your child had any scans or tests done before the appointment, the doctor will look at them and explain what they see. We may also order new scans if we need more information.
   
6. Finally, we will come up with a comprehensive and collaborative plan for your child.
   
7. We always encourage families to write down any questions you have before the appointment. This will help you remember what you want to ask the doctor.
   
   

Many families have been where you are right now. It's okay to feel worried or unsure. But pediatric neurosurgeons are experts in caring for children with brain and spine conditions.

Dr. Hersh: We love questions, so ask away! Here are a few we get a lot:

• What do you think is causing my child's symptoms?
• Does my child need surgery? If so, what will recovery be like?
• What happens if we decide not to get surgery?
• Are there other treatment options, like a minimally invasive approach ?
• How often will we need follow-up visits? And with which other pediatric specialists?

We promise-we're here for you and it's our job to explain things in ways you can understand. All you have to do is ask!

Dr. Martin: That highly depends, but usually:

• Your child's care team may want to watch and wait. This means we will monitor your child's condition with regular checkups.
• We may recommend more tests, like another scan.
• We might suggest physical therapy or medication if surgery is not needed.
• In some cases, we may say that surgery is the best option.

If surgery is the best option, the doctor will explain what it will involve, and how to prepare. You will have time to think and ask more questions.
Many families have been where you are right now. It's okay to feel worried or unsure. But pediatric neurosurgeons are experts in caring for children with brain and spine conditions. They will help guide you every step of the way.

We always tell parents they are doing the right thing by taking their child to get checked out. Whether it leads to surgery or just careful watching, your child is in the best hands.

Bethany Simonetti MSN, APRN, FNP-BC, is a Nurse Practitioner in the Division of Neurosurgery at Connecticut Children's. Bethany's clinical interests include perioperative care of neurosurgical patients, incisional care postoperatively to optimize healing, and patient education to minimize stress during the surgical process. In her free time, Bethany enjoys traveling and spending time with her husband and children.

Dr. Hershis a pediatric neurosurgeon at Connecticut Children's. His clinical and research interests include craniofacial surgery, endoscopic surgery, fetal surgery, neurosurgical oncology (brain and spinal cord tumors), epilepsy surgery, and congenital anomalies including spina bifida and Chiari malformations. He has a particular interest in using advanced technologies to optimize outcomes for his patients.