Pediatric Concussions

Care for Pediatric Concussions at MedStar Georgetown University Hospital

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Make an Appointment

For more information or to make an appointment with a pediatric specialist, call our scheduling line: 

Phone: 202-243-3499

Concussions are common in childhood, particularly among young athletes. While most children do not suffer lasting effects from a mild concussion, brain injuries can be dangerous and should always be taken seriously. The Division of Pediatric Neurology at MedStar Georgetown University Hospital offers expert care.

FAQs About Pediatric Concussions

What is a concussion? 

A concussion, also called a traumatic brain injury or TBI, is a type of injury that affects brain functioning. Concussions are triggered by the brain hitting up against the skull, affecting the typical performance of the nervous system.

What causes a concussion? 

Concussions are caused by an impact to the head, or by the head being suddenly and forcefully jerked or jolted. Many children experience a concussion due to a fall, car or bicycle crash, or sports injury.

What are the signs and symptom of a concussion?

The signs and symptoms of a concussion can be difficult to detect. Young children may not have the words to report on their symptoms, and even older children and young adults may not be able to accurately self-assess their symptoms in the aftermath of a head injury. It is, therefore, important that both children and adults are aware of what to look for. If you think your child has experienced even a mild concussion, you should call your doctor right away. In some cases, a concussion will require immediate emergency care. When in doubt, head to the Emergency Department.

Signs and symptoms of a concussion include:

  • Unusual behavior, including changes to personality or trouble controlling emotions
  • Delayed physical or verbal reactions
  • Changes to balance or coordination
  • Nausea
  • A dazed expression
  • Blurred or double vision
  • Headache
  • Dizziness
  • Difficulty focusing or feeling foggy
  • Sensitivity to lights or sound
  • Feeling sleepy or experiencing having difficulty sleeping

Signs that should prompt an immediate visit to the Emergency Department include:

  • Loss of consciousness (even briefly)
  • Memory loss or confusion
  • Looking very tired or not waking up from sleep
  • One pupil looking larger than the other
  • Convulsions or seizures
  • Difficulty recognizing people or places
  • Increasing agitation or confusion
  • Inconsolable crying
  • A headache that gets worse or won’t go away
  • Weakness, numbness, or inability to coordinate movements
  • Vomiting or persistent nauseous
  • Slurred speech

Who is at risk for a concussion?

Traumatic brain injuries account for nearly three million emergency department visits, hospitalizations, and fatalities in the U.S. each year. Adolescents, young adults, and older adults are at the highest risk. Older adults (age 75 and up) are most likely to suffer a fatality related to a traumatic brain injury, but it is important to take a concussion seriously at all ages.

Children who play sports are at particularly high risk of experiencing a concussion. Contact sports such as football, hockey, rugby, and soccer have the highest rates, and experiencing one concussion increases the risk for a second (even from a lesser impact). It is important to take sports safety seriously by making sure that children wear appropriate headgear, being aware of the signs of a concussion, and removing children from play if they experience a head injury.

When young athletes experience a head injury during a sports activity, can they continue to play?

No—athletes who are suspected of suffering a concussion should be removed from practice or play immediately, even if the symptoms seem mild. This guidance is in accordance with Maryland and Washington, D.C., athletic concussion prevention laws.

It is can be difficult to detect if a head injury has caused a concussion, particularly because symptoms may not become obvious until hours or days later. Children who have suffered a concussion may also not be able to report on their symptoms reliably. This means it important for coaches, parents, and teammates to know the signs and play it safe. By removing children from practice or gameplay, you can eliminate the risk of further injury or a second concussion.

What services do we offer at the Division of Pediatric Neurology?

Even children who have already received an appropriate diagnosis of traumatic brain injury from their primary care physician or a physician at the Emergency Department may require specialized follow-up care. The Division of Pediatric Neurology can help assess persistent symptoms and develop a recovery plan.

The team of brain experts at the Division of Pediatric Neurology evaluate neurological functioning, balance, and cognition. If a child has experienced a sports injury and was initially screened with ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing, a computerized test used by some schools for suspected concussions), this testing may be repeated to assess for changes.

After assessing a child’s functioning, our team will provide recommendations about when it is safe to return to school or sports, what accommodations may be needed, and additional therapies that may be beneficial (for examine, occupational, physical, vestibular, and/or speech and language therapy).

Pediatric Spasticity

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Make an Appointment

For more information or to make an appointment with a pediatric specialist, call our scheduling line: 

Phone: 202-243-3499

Pediatric Spasticity Specialists

MedStar Georgetown University Hospital provides advanced care for pediatric spasticity, including a specialty clinic offered at our Tenleytown location.

Spasticity has several possible causes, can affect different parts of the body, and can significantly range in severity—so the Division of Pediatric Neurology tailors our care to the needs of each individual patient. No matter your child’s needs, our expert team can create a care plan to help achieve the best possible clinical outcomes.

FAQs About Pediatric Spasticity

What is spasticity? 

 Spasticity is a disorder that affects muscle control. Children with spasticity may experience muscle jerks, tightness, or involuntary movements.  While the severity of symptoms varies widely, spasticity often causes pain and difficulty with day-to-day tasks or mobility. Treatment can help increase comfort and functioning.

What causes spasticity?

Spasticity is caused by abnormal communication between the body’s nerves and muscles. This problem with the central nervous system has a variety of possible causes, including strokes, brain or spinal cord injuries, multiple sclerosis, and cerebral palsy. In children, cerebral palsy is the most common cause of spasticity.

How is spasticity treated?

At the MedStar Georgetown Division of Pediatric Neurology, many types of treatment are available for children with spasticity. Our interdisciplinary team evaluates each child, discusses the treatment options with families, and creates highly-customized care plans.  Treatment options may include:

  • Oral medications
  • BOTOX® injections to temporarily relax muscles for three to six months
  • Intrathecal Baclofen Therapy (sometimes called ITB or a Baclofen Pump), a treatment which uses a surgically-placed pump to deliver a drug that reduces spasticity
  • Serial casting, a treatment that uses a series of casts to gradually stretch muscles
  • Physical therapy and occupational therapy

Pediatric Stroke

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Make an Appointment

For more information or to make an appointment with a pediatric specialist, call our scheduling line: 

Phone: 202-243-3499

The Division of Pediatric Neurology at MedStar Georgetown University Hospital is the only Comprehensive Stroke Center in the Washington, D.C., area to provide specialized pediatric stroke care. Our physicians are nationally-renowned for their expertise.

FAQs About Pediatric Stroke

 

What is a stroke, and how common are they for children?

A stroke is a type of cardiovascular disease that interrupts the flow of blood and oxygen to the brain. Strokes may be ischemic (caused by a blocked blood vessel) or hemorrhagic (caused by a burst blood vessel).

Strokes are often mistakenly thought of as a problem that affects only the elderly. Although strokes are more common in adults, they can also affect infants and children. As many as one in 1,600 infants experience a stroke at birth each year, as do as many as 13 in 100,000 older children.

What are the risk factors for a pediatric stroke?

Risk for childhood stroke can be increased due to maternal factors, congenital heart defects, infections, immune disorders, blood disorders, or trauma (for example, a head injury).

What are the signs and symptoms of a pediatric stroke?

Because it is critical that children who have experienced a stroke receive medical care as quickly as possible, it is important to know the signs.  For infants, these signs include seizures (marked by sudden stiffness or the whole body or part of the body, twitching or spasms, or non-responsiveness) or weakness on one side of the body. 

Signs of a stroke in older children include headaches; weakness or numbness on one side of the body; drooping of one side of the face; or changes to speech, vision, or movement.

How are pediatric strokes assessed and treated?

If you think your child is having a stroke, you should get them to the Emergency Department without delay. Early intervention from a specialized stroke team can help minimize injury to the brain, and prevent complications or permanent disability.

At the hospital, your child will receive imaging tests—for example, CT scans, MRIs, or angiograms—to detect any bleeding in the brain. An echocardiogram may be used to examine the structure of your child’s heart. Neurological tests and other exams may also be conducted. 

If needed, your child may be given anticoagulant medication or aspirin to prevent blood clots. Some children will need to remain on those medications long-term. Depending on the cause and severity of the stroke, other treatments may also be needed.

Children who have had a stroke require medical monitoring and, often, rehabilitation services like physical, occupational, and/or speech therapy. MedStar Georgetown offers a full spectrum of follow-up care. With quality medical care, many children make a full recovery from a stroke.

 

Community Pediatrics

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The Division of Community Pediatrics at MedStar Georgetown University Hospital provides the quality health care families need, right in local neighborhoods and schools.  Our expert team offers a full range of healthcare services to every child in our community, regardless of insurance status. Since 1992, the Division of Community Pediatrics has served more than 7,000 children with over 60,000 patient visits.

“We know that in order to live healthy lives, children and families need access not only to high quality health care, but also to safe and strong neighborhoods, an excellent education, healthy food, and active play” says Division Chief, Janine A. Rethy, MD, MPH.

More Information

To learn more about our Community Pediatrics program, please call

202-444-8888

Vision and Mission of Community Pediatrics 

In line with MedStar Georgetown’s vision to be the trusted leader in caring for people and advancing health, the Division of Community Pediatrics ensures that every child has the opportunity to thrive and be healthy. We are committed to helping our community attain health equity.

Our team provides access to evidence-based, comprehensive, coordinated, compassionate health care to those who need it most. Our services and programs aim to decrease health disparities and train the next generation of community-oriented health care professionals.

Clinical Services from Community Pediatrics 

This map displays where our clinical services are located.

Community Outreach and Engagement

Community Pediatrics is dedicated to promoting health through both service and education. Our team participates in many community outreach and engagement activities throughout the year.

Innovation and Partnerships

We partner with clinical, community, and government agencies to create innovative solutions for optimizing health and well-being. Some examples include:

Community Pediatrics Medical and Academic Education

We are committed to training the doctors of tomorrow to deliver high-quality, community-oriented care. The Division of Community Pediatrics serves as a critical educational component of the Department of Pediatrics medical student and residency training programs and offers the opportunity for Fellowship training in Community Pediatrics.  In addition to teaching the fundamentals of primary community care, our Community Pediatrics medical education program offers learners the opportunity to engage in experiential community health learning at all of our sites, as well as with partner community service providers such as D.C. Child and Family Services Agency, Joyful Markets, and WIC.  Our faculty engages in ongoing research, quality improvement, and evidence-based program development and evaluation. We mentor students, residents and fellows to learn through these projects, and often to lead them.

Our Team

Our highly trained team includes physicians, nurses, nurse practitioners, social workers, a registered dietitian, an exercise physiologist, mental health providers, and an administrative support team.  We partner with local schools and community groups to build strong relationships with the families we serve.

Pediatrics Providers

Gynecologic Surgery

The Section of Benign Gynecologic Surgery at the MedStar Georgetown Department of Obstetrics and Gynecology (Ob/Gyn) offers expert surgical care for all non-cancerous gynecological conditions.

Gynecologic conditions can often be treated non-surgically. When surgery is the best option, however, our expert team of board-certified gynecologic surgeons are here to help you get well—safely and comfortably. Whenever possible, we use minimally-invasive, laparoscopic, vaginal, and robot-assisted approaches. These techniques offer better outcomes, faster healing, less scarring, and lower risks of complications.

We can help patients overcome a wide range of gynecological health challenges, including: infertility, endometriosis, fibroids, abnormal uterine bleeding, uterine polyps, ovarian cysts, pelvic pain, pelvic organ prolapse, and bladder disorders. Patients with gynecological cancers are treated through the MedStar Georgetown Cancer Institute.

Our Ob/Gyn providers work closely with other departments throughout MedStar Georgetown University Hospital, including the department of Bloodless Medicine and Surgery for patients who cannot or prefer not to receive blood transfusions during surgery. With a wide variety of capabilities all available at one location, you can seamlessly access all of the care you need.

Our gynecologic surgical capabilities include:

Make an Appointment

For more information or to schedule an appointment with a women's health specialist, call our scheduling line or use the online request form below:

Phone: 202-444-0362

 Gynecologic Surgery Specialists

Office Diagnostic Hysteroscopy

An Office Diagnostic Hysteroscopy can be used to diagnose problems in a woman’s uterus. To complete the procedure, a thin tube (scope) equipped with lights and a camera is inserted through the vagina. The Ob/Gyn then guides the scope’s movement using a video screen.

Hysteroscopy is a minimally-invasive procedure that can be completed right in the doctor’s office. Since the approach does not require any incisions, there is no healing time required after the procedure and patients can return home right away.

Hysterectomy

A hysterectomy is the surgical removal of the uterus. This procedure can be used to treat several types of gynecological conditions—including cancer, non-cancerous tumors, fibroids, endometriosis, uterine prolapse, abnormal bleeding, and chronic pain.  The Section of Benign Gynecologic Surgery offers laparoscopic, vaginal, and robot-assisted approaches for this procedure, as well as traditional open/abdominal approaches when necessary.  

  • Laparoscopic hysterectomy: To perform a hysterectomy laparoscopically, the surgeon creates a very small incision near the patient’s belly button. After inserting a thin tube (scope) equipped with tiny surgical tools, lights, and a camera, the surgeon uses a video screen to guide the procedure.
  • Robot-assisted laparoscopic hysterectomy: This type of hysterectomy is similar to the laparoscopic approach described above. It begins with a small abdominal incision and the insertion of a scope. The surgeon uses a computer to manipulate the surgical instruments, a technique that can allow for more precise movement in small spaces.
  • Vaginal hysterectomy: This approach is performed completely through the vagina, without any abdominal incisions.

Myomectomy

Fibroids are a very common type of benign (non-cancerous) tumor that can develop in the uterus.  Although many women experience no symptoms, fibroids may cause menstrual bleeding, frequent urination, fertility problems, or pain.  In these cases, a myomectomy procedure to remove fibroids may be helpful.

Unlike a hysterectomy, a myomectomy allows a woman to keep her uterus—only the fibroids are removed. This makes it a good option for women who may want to have a baby in the future.

We offer several minimally-invasive types of myomectomy:

  • Laparoscopic myomectomy: To perform this procedure, the surgeon creates a very small incision near the patient’s belly button. After inserting a thin tube (scope) equipped with tiny surgical tools, lights, and a camera, the surgeon uses a video screen to guide the operation.
  • Robot-assisted laparoscopic myomectomy: This approach is similar to the laparoscopic procedure described above, beginning with a small abdominal incision and the insertion of a scope. However, the surgeon uses a computer to manipulate the surgical instruments. This can allow for more precise movement in small spaces.
  • Hysteroscopic myomectomy: During a hysteroscopic myomectomy, the surgeon inserts the scope through the vagina. This is an option for fibroids located in certain areas of the uterus.

Cancer Risk Reductive Surgery

Genetics can put women at higher risk for certain types of cancer. For instance, women who have a gene mutation called BRCA are at increased risk of ovarian and breast cancer.  

Risk-reducing surgery can help prevent cancer from developing. Several types of surgery fall into this category of procedures, including removal of the ovaries (prophylactic oophorectomy) or the uterus (hysterectomy).

For many women, these procedures offer great peace of mind. For others, a different treatment approach is the right fit. Your clinician will help you make the decision that is right for you.

Fertility Surgery

Gynecological conditions can have an effect on your fertility, make it more difficult to become pregnant or to have a healthy full-term pregnancy.  We offer several surgical techniques to improve fertility.

  • Uterine septoplasty: Women with a septate uterus have a thin wall, or membrane, that divides the inner part of the uterus into two sections. This is a common cause of fertility problems. A uterine septoplasty is a procedure to remove the membrane dividing the uterus. This procedure is performed using a minimally-invasive approach called hysteroscopy that requires no incisions.
  • Treatment of endometriosis: Endometriosis is a condition in which the tissue that normally grows inside the uterus grows outside the uterus. Endometriosis is common, but it can be painful and cause fertility issues. We can treat this condition in several ways, including medication or surgery to remove or treat the endometriosis.
  • Adhesiolysis: Some women have scar tissue in the pelvis, a condition most commonly caused by prior surgeries. When appropriate, pelvic scar tissue can be removed—typically in a minimally-invasive fashion—through a procedure called Adhesiolysis. Adhesiolysis can be helpful to patients who are experiencing pain or fertility issues as a result of the scar tissue.

Ovarian Surgery

The ovaries can be affected by several kinds of benign conditions, including the growth of non-cancerous tumors or fluid-filled sacs called cysts.  Our team can treat the full range of ovarian conditions. Typically, these procedures can be done using minimally-invasive approaches that allow for faster healing and fewer complications.

Endometrial Ablation

If you have extremely heavy or long menstrual cycles, endometrial ablation may a treatment option.  This procedure removes the lining of the uterus so that menstrual flow is greatly reduced or stopped. Typically, this procedure is not done on women who want to have children because it can increase the risks of pregnancy. This procedure is typically performed using hysteroscopy, a minimally invasive approach that requires no incisions.

Polypectomy

Polyps are a type of growth that can develop on the lining of the uterus or cervix. While polyps are usually benign (non-cancerous), they can sometimes become cancerous over time. They can also cause problems like heavy or irregular menstrual periods, bleeding between periods or after menopause, reduced fertility, or pain. 

A polypectomy is a procedure used to remove polyps. This procedure can often be performed hysteroscopically. This means that the surgeon inserts a thin tube (scope) equipped with tiny surgical tools, lights, and a camera through the vagina—no incisions required. The surgeon uses a video screen to guide the procedure. 

Blue Light Cystoscopy

Blue Light Cystoscopy with Cysview® is a new, FDA-approved technique for detecting bladder cancer.

Cystoscopy (or bladder scope) is a procedure that uses a thin tube equipped with a light, camera, and small surgical tools to inspect the lining of the bladder.  Traditionally, cystoscopy uses a white light source to illuminate the physician’s examination. If potentially cancerous tissues are detected, physicians may remove a small tissue sample for later biopsy or remove the tumor entirely.

Bladder tumors can be small or difficult to see, and up to 30% of tumors are not detected by traditional cystoscopy. Blue Light Cystoscopy differs from traditional cystoscopy in two ways: the addition of a blue light, and the introduction of a special Cysview imaging solution.

Cysview solution is introduced into the bladder about an hour before Blue Light Cystoscopy, selectively absorbing into any cancerous tissue that may be present. During the procedure, the physician first examines the bladder with the traditional white light. Next, a blue light is used. The Cysview solution glows fluorescent pink under the blue light, highlighting tumors that may otherwise have been missed.

Used together with traditional cystoscopy, Blue Light Cystoscopy significantly increases the detection of bladder tumors, allowing for earlier treatment, more complete removal of tumors, and improved patient outcomes.

Make an Appointment

For more information or to schedule an appointment with a urology specialist, call our scheduling line: 

202-444-4922

 

Hematopathology

MedStar Georgetown University Hospital is staffed with two board-certified hematopathologists  (Dr. Metin Ozdemirli and Dr. Bhaskar Kallakury) that are responsible for the diagnosis of hematologic disorders, which include benign and neoplastic disorders of  blood cells, bone marrow, nodal and extranodal lymphomas and histiocytic disorders. Comprehensive analysis using morphology, flow cytometry, immunohistochemistry, in situ hybridization, electron microscopy and molecular pathology  according to the complexity of the cases  allows timely diagnosis and treatment of  patients by Lombardi clinicians.

Director

  • Dr. Metin Ozdemirli, Professor, Department of Pathology, Director of Hematopathology; Program Director, Hematopathology Fellowship

Phone: 202-784-3614

Location

3900 Reservoir Rd, NW
Med-Dent Bldg SW 201
Washington, D.C. 20007

Surgical Pathology

Our Surgical Pathology department services all areas within Medstar Georgetown University Hospital including the Operating Rooms, Labor and Delivery, and Endoscopy. We provide integrated pathology services to offsite MedStar Health locations including Lafayette Centre and MedStar Brandywine. Our laboratory includes Pathologists’ Assistants (PA’s), PA students, and pathology residents who are trained to perform accurate and timely evaluation and processing of all pathological specimens. Our PA’s and residents perform a variety of responsibilities including gross examination, dissection, description, specimen radiography, specimen photography, intraoperative consultations including frozen sections, tissue banking, and triaging of specimens. The laboratory personnel will obtain patient clinical history, describe the gross presentation of the tissue, and prepare the tissue for processing for light microscopy evaluation. Tissue is obtained in collaboration with multiple departments for flow cytometry, electron microscopy, immunofluorescence, and research. MedStar Georgetown University Hospital prides itself on its commitment to academic research through its participation in the tissue processing for hundreds of research cases per year.   

For imformation on submitting a case to the Department of Surgical Pathology, please contact the pathology customer service officer at (202) 784-3614.

Directors

Phone: 202-444-3620
Fax: 202-444-0343

Location

CCC Building, OR level, room COR88
3900 Reservoir Rd NW,
Washington D.C 20007

Neuropathology

The Neuropathology service is led by Dr. Brent Harris and offers full diagnostic laboratory services to support the MedStar Health network.  Institutional and consult surgical pathology services are available for CNS/PNS tumors and other lesions including coordination for advanced molecular testing.

In addition, MedStar Georgetown University Hospital functions as a full muscle and nerve diagnostic laboratory. Muscle biopsy helps to identify unexplained muscle weakness, fatigue and elevated CPK, and distinguish between dystrophies, metabolic myopathies, inflammatory myopathies, and neurogenic myopathies. Nerve biopsies can assist with diagnosis of CIDP, vasculitis, amyloidosis, and other neuropathies. Muscle and nerve biopsy tissues can be sent to MedStar Georgetown using our easy-to-use kits that are sent to you free of cost. We accept all of MedStar Georgetown biopsies as well as consults from around the country.

Services Include:

  • Clinical evaluation
  • Tissue preparation
  • Pathological interpretation including advanced histochemistry, nerve teasing, and electron microscopy

To request a muscle/nerve biopsy kit, contact the neuropathology lab at least 48 hours before the muscle biopsy is collected at (202) 687-4282. Biopsies are accepted Monday through Friday. Turnaround time is 7 to 10 days.

Additional neuropathology services such as CNS biopsy, autopsy consultations, and brain biobanking are available from the Georgetown Brain Bank. For more information about diagnostic services provided please contact the Department of Pathology at (202) 784-3614

Director

  • Dr. Brent Harris

Phone: 202-784-3614
Fax: 202-687-8935

Location

3900 Reservoir Rd NW,
Washington D.C 20007