Benjamin C Warf
Benjamin C Warf, M.D.
Professor of Neurosurgery and a Department of Global Health and Social Medicine Affiliate

My research efforts have focused primarily on hydrocephalus in the developing world and in the United States, defining, validating, and reproducing a novel, low-cost method for treating this condition.

During my time as a neurosurgeon in Uganda, I was the first to identify neonatal infection as the most common cause of hydrocephalus in East Africa. I uncovered a correlation between the rainfall cycle and these infections. I pioneered and tested an alternative to shunts for this population, combining endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC). Much of my research has focused on outcomes for this surgery.

Our work was the first to demonstrate equivalence in early childhood development between ETV/CPC and shunt treatment and the first to show the effect of previous ETV or CPC on subsequent shunt function. My research analyzed the disease burden and economic impact for infant hydrocephalus in sub-Saharan Africa, and provided a detailed cost-benefit analysis of its treatment—among the first studies to demonstrate cost-effectiveness for any surgical procedure in a setting with limited resources.

Clinical outcomes have been an important part of my research. I documented the 5-year survival rates and functional outcomes for Ugandan infants treated for myelomeningocele and for post-infectious-hydrocephalus. I have also reported equivalent outcomes between an inexpensive Indian shunt and an American shunt costing 20 times more.

In 2012, I was awarded a grant from the NIH to carry out a prospective randomized trial of developmental and brain volume outcomes for shunt placement versus ETV/CPC in Ugandan infants with post-infectious hydrocephalus. This work has now received additional NIH funding for its completion and extension through a grant that began in August 2015.

By invitation, I have presented our work at the CDC as well as the NIH. I have testified before the House Subcommittee on Africa, Global Health, and Human Rights, which resulted in the introduction of the International Hydrocephalus Treatment and Training Act (HR 3525) into the House of Representatives, and the subsequent introduction of HR 1468, the “Global Brain Health Act of 2015”.

My research, teaching, and leadership in both Africa and North America continue to inform and benefit one another with the ultimate goal of improving access to optimal, evidence-based, and sustainable treatment for children with hydrocephalus and spina bifida everywhere.

The Incidence of Postoperative Seizures Following Treatment of Postinfectious Hydrocephalus in Ugandan Infants: A Post Hoc Comparison of Endoscopic Treatment vs Shunt Placement in a Randomized Controlled Trial.
Authors: Authors: Punchak M, Mbabazi Kabachelor E, Ogwal M, Nalule E, Nalwoga J, Ssenyonga P, Mugamba J, Rattani A, Dewan MC, Kulkarni AV, Schiff SJ, Warf B.
Neurosurgery
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Infection risk for Bactiseal Universal Shunts versus Chhabra shunts in Ugandan infants: a randomized controlled trial.
Authors: Authors: Mbabazi-Kabachelor E, Shah M, Vaughan KA, Mugamba J, Ssenyonga P, Onen J, Nalule E, Kapur K, Warf BC.
J Neurosurg Pediatr
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Reversible intracranial hypertension following treatment of an extracranial vascular malformation: case report.
Authors: Authors: Pricola Fehnel K, Klein J, Warf BC, Smith ER, Orbach DB.
J Neurosurg Pediatr
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Children with spina bifida in Eastern Uganda report a reasonable quality of life relative to their healthy school-attending peers.
Authors: Authors: Sims-Williams HJ, Sims-Williams HP, Mbabazi Kabachelor E, Magombe J, Warf BC.
Arch Dis Child
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Patterns of Hydrocephalus in Rural Haiti: A Computed Tomography-Based Study.
Authors: Authors: Barthélemy EJ, Valtis YK, Cochran MF, Martineau L, Park K, Mendel JB, Warf B, Berkowitz AL.
World Neurosurg
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Subspecialty pediatric neurosurgery training: a skill-based training model for neurosurgeons in low-resourced health systems.
Authors: Authors: Dewan MC, Onen J, Bow H, Ssenyonga P, Howard C, Warf BC.
Neurosurg Focus
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Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide.
Authors: Authors: Dewan MC, Baticulon RE, Rattani A, Johnston JM, Warf BC, Harkness W.
Neurosurg Focus
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Learning Based Segmentation of CT Brain Images: Application to Postoperative Hydrocephalic Scans.
Authors: Authors: Cherukuri V, Ssenyonga P, Warf BC, Kulkarni AV, Monga V, Schiff SJ.
IEEE Trans Biomed Eng
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De Novo Mutation in Genes Regulating Neural Stem Cell Fate in Human Congenital Hydrocephalus.
Authors: Authors: Furey CG, Choi J, Jin SC, Zeng X, Timberlake AT, Nelson-Williams C, Mansuri MS, Lu Q, Duran D, Panchagnula S, Allocco A, Karimy JK, Khanna A, Gaillard JR, DeSpenza T, Antwi P, Loring E, Butler WE, Smith ER, Warf BC, Strahle JM, Limbrick DD, Storm PB, Heuer G, Jackson EM, Iskandar BJ, Johnston JM, Tikhonova I, Castaldi C, López-Giráldez F, Bjornson RD, Knight JR, Bilguvar K, Mane S, Alper SL, Haider S, Guclu B, Bayri Y, Sahin Y, Apuzzo MLJ, Duncan CC, DiLuna ML, Günel M, Lifton RP, Kahle KT.
Neuron
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Noninvasive Thermal Evaluation of Ventriculoperitoneal Shunt Patency and Cerebrospinal Fluid Flow Using a Flow Enhancing Device.
Authors: Authors: Hameed MQ, Zurakowski D, Proctor MR, Stone SSD, Warf BC, Smith ER, Goumnerova LC, Swoboda M, Anor T, Madsen JR.
Neurosurgery
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