Meet Sarah's Nuerosurgen: Dr. Mark Proctor

Mark  R.  Proctor, MD, FAANS

Mark Robert Proctor was born on October 22, 1964 in New York City and raised on Long Island as the youngest of three children. His parents, Roslyn and Seymour, ran a small printing shop, and he comes from a long lineage of printers. He entered Dartmouth College in 1982, was a varsity heavyweight oarsman, rowing all four years, and graduated with a major in French. In 1986 he entered Columbia University College of Physicians and Surgeons, obtaining his MD degree in 1990. He was an active rugby player and team captain at Columbia. Mark did his general surgery internship at Columbia Presbyterian Hospital followed by neurosurgery residency at Georgetown University. In 1997, he went to Children's Hospital Boston for his Pediatric Fellowship. He joined the faculty at Children's Hospital and Brigham and Women's Hospital in 1998 as an instructor of surgery at Harvard Medical School. He became Assistant Professor in 2003 and Associate Professor in 2010. Mark has served as the Associate Director of the Brigham and Children's Residency Training Program since 2000, directing the residency training at Children's Hospital. He served on the Admissions Committee at Harvard Medical School from 2001 to 2004 and was appointed Vice -Chairman of Neurosurgery at Children's Hospital in 2012. His clinical interests include craniofacial disorders, complex pediatric spinal disorders, and neurotrauma. Nationally, Mark has been very involved in advocacy and injury prevention. He has been on the board of the Thinkfirst National Injury Prevention Foundation since 2002 and served as Chairman of the Board from 2009 - 2011. He is on the Executive Committee of the Pediatric Section of the AANS/CNS, served as the Membership Chair from 2007-2010, and currently is the Treasurer. He is a Member at Large of the New England Neurosurgical Society and also Vice President of the Massachusetts Neurosurgical Society. Mark married Dr. Charlotte McKee, a medical school classmate, in 1991. She is a pulmonologist and works in the field of lung transplantation and with the biotech industry. They live in Newton, Massachusetts with their two children, Maxwell and Kenny. They enjoy bicycle riding and boating at their lake house in NH, and Mark is also an avid squash player.

First Check-In Report

We were just updated that Sarah is doing well. Once anesthesia was set and she was positioned correctly the surgery (first cut as they say) began at 8:30pm. Dr. Mark Proctor who is Sarah's Neurosurgeon began the surgery. He will open up the area which requires a lot of attention to detail. He is preparing the area for Dr. Meara who is Sarah's Plastic Surgeon to harvest bone and try to fill in the bony gaps.

"The Thundermans"

Pre-Op waiting includes watching "The Thundermans"

We are here!

We are here and ready as we can be. Our scheduled arrival time was 6am for 7:30am surgery start time. Sarah although nervous and a little sad is being a real trooper. Here she is in the waiting room. Bill and I keep making corny jokes to keep the mood light.

What the Surgery Involves

Cranioplasty is as a surgery done to improve the symmetry and shape the head. It involves the neurosurgery repair of irregularity or imperfection in the skull. The major purpose of cranioplastic surgery is to provide protection for the brain. Since cranioplasty is a surgery of the brain which is the most sensitive part of human organs, it is a complicated procedure. It requires a surgeon who is highly  professional, skilled and experienced. The surgery involves the use of a bone graft to repair a gap or defect in the vault of the skull. The graft is done using bone from the pelvis, ribs, or part of an adjacent skull, even suitable synthetic materials such as silastic or tantalum can be used.

What are the causes of abnormalities of the skull?

There are several conditions which can lead to abnormalities in skull structure, such as

•  premature close of the cranial sutures
•  Incapability of the skull to expand as the brain grows.
•  Some hereditary conditions that can cause children to be born with skull irregularities.
•  Persistent damage to the skull as a result of trauma.
•  A hole in the head.
•  The defect in some places that leaves the brain exposed that could cause severe damage
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  How is Cranioplasty performed?

   Cranioplasty is a procedure that takes approximately to replace a portion of the skull with either original bone tissue or plastic implants.
•  The patient is given general anesthetic and is positioned with the bone defect uppermost.
•  The area of incision is shaved and prepared with antiseptic.
•  The patient is covered in drape in such a way only the incision can be viewed.
•  Local anesthetic is injected and then the area is cut.
•  The scalp is cut apart from the ‘dura’, the underlying covering of the brain, and the edges of the surrounding bone are cleaned to let the graft to stick.
•  The surgeon will decide on the source of the graft. The iliac bone bounding the pelvis, ribs and even a part of adjacent skull bone can be used.
•  It is also possible to fix a gap in the skull by using synthetic material. Materials such as tantalum, silastic, titanium plate, rib graft, prefabricated acrylic, synthetic bone substitute, and other similar material manufactured for the fast use of implantation into the body can also be used.
•  The original bone or a replacement that is kept ready is placed in the defect area and secured with screws, plates or with special discs.
•  If the graft is not available, the patient is treated from the chosen material.
•  This is shaped to fit.
•  This is also fixed to the surrounding area.
•  Once plated everything is repositioned.
•  The skin is then closed either with nylon suture or with special staples.

What is the recovery time?

•  It is essential for the patient to be in hospital.
•  The ease of the operation relies on the cause of the bone defect.
•  If the underlying covering of the brain, the dura mater, is unbroken and healthy, the operation is straightforward and uncomplicated.
•  The patient is discharged about 5-7 days.
•  The sutures are removed 5-10 days after.

Vacation at Old Orchard Beach

We spent last week at Old Orchard Beach, Maine. This is one of Sarah's favorite places and what she describes as her happy place. We spent some nice family time together which was a happy distraction from her surgery. Sarah enjoyed riding the waves on her boogie board, making castles in the sand, and riding the amusement rides downtown. She had the chance to just be a kid with no restrictions cartwheeling in the sand. Bill and I enjoyed watching her! She and Jason had loads of laughs throughout the week including burying each other in the sand.

Why Another Surgery?

Sarah's upcoming surgery is to repair two "holes" located on each side of her skull. This is a picture of her CAT Scan which helps to identify what needs to be repaired. This surgery is necessary because without it there is no skull covering that portion of her brain. Her surgeons will harvest bone from the back of her skull to place over these "holes". Heading this surgery will again be what we call our "Dream Team" comprised of Plastic/Cranial Facial Surgeon, Dr. John Meara and Pediatric Neurosurgeon Dr. Mark Proctor. I cannot say more about these fine doctors and their staff.