• Cochrane, D. Douglas


    Investigator, BC Children's Hospital
    Investigator, Emeritus
    Professor, Division of Pediatric Neurosurgery, Department of Surgery, University of British Columbia
    Patient Safety and Quality Officer for the Province of British Columbia
    Chair of the BC Patient Safety and Quality Council

    Degrees / Designations
    Primary Area of Research
    Childhood Diseases
    Secondary Area(s) of Research
    Lab Phone
    Helen McGregor
    Assistant Phone
    Mailing Address
    BC Children's Hospital

    Room K3 -216
    4480 Oak Street
    Vancouver, BC V6H 3V4

    Affiliate Websites
    Research Areas
    • Neuroimaging
    • Brain mapping functional MRI, CFD, FEM
    • Spinal dysraphism
    • Craniosynostosis
    • Myelomeningocele
    • Morphometrics
    • Morquio
    • Achondroplasia
    • Spondyloepiphyseal dysplasia
    My research interests are in three principle areas:
    • Use of central nervous system imaging technologies to define physiological parameters or relevance to the treatment of children with hydrocephalus

    • Health care systems development and change, focusing on the development of skills in providers through the analysis of risk and safety during surgical care.

    • Spinal cord disorders affecting children including spina bifida and occipital-cervical cord compression.

    Current Projects

    Using CNS imaging technologies to define physiological parameters as they apply to infants and children with hydrocephalus, the directions being taken at the present include the development of techniques to describe the morphological changes in the ventricular system that occur as a result of ventricular shunting or third ventriculostomy. This is based imaging and 3D morphometric analysis. It is also anticipated that MR imaging, using time gated sequences or tensor imaging will allow non-invasive assessments of intracranial compliance. Using such non-invasive measures will assist in the determination of optimal shunting for children with hydrocephalus. This work applies computational fluid dynamic and finite element analysis techniques to biological problems.

    Health care programme development, evaluation and service planning are fundamental to the provision of optimal care. Within the discipline of pediatric neurosurgery, the geographical diversity of the western provinces and the limitations imposed by available subspeciality staff and equipment force the evaluation of operative services from the perspecitve of patient care and health economics. Studies have been completed describing the influence of surgeon experience on shunt failure rates in hydrocephalic patients and on the epidemiology of pediatric neurosurgical practice in Western Canada . Similar analyses are applicable to other low frequency, high risk areas such as cardiac surgery.

    Improving the quality of care for children with pediatric neurosurgical problems can be approached from the perspective of hypothesis-based studies or by the application of knowledge already known. To apply either effectively, coordinated, structured and focused collaboratives are required. Due to the low frequency and the high risk of conditions treated by pediatric neurosurgeons, a network is being developed to build on the successful Pediatric Neurosurgery Study Group through the application of quality monitoring and improvement techniques.

    Spina bifida is the commonest multisystem congenital anomaly seen in humans. The evaluation of interventions is critically important in optimizing patient function and developmental outcomes. Clinical problems studied in this population include the role of elective caesarian section as an attempt to minimize neurological defects and the role of cord untethering as a tool to maximize spinal function in the child. Lipomylemeningocele (lipoma of the conus) patients have been reviewed and the long-term outcome has been quantified and clarified. Programme evaluations have been performed for the benefit of our multidisciplinary clinic and patients .

    Compression of the spinal cord by tumours, congenital malformations and bone abnormalities is devastating for patients, as the possibility for permanent paralysis affecting the arms, legs, breathing, bladder, bowel and sexual functions are high. Compression is particularly dangerous when if occurs at the top of the spinal canal. The Departments of Orthopedics and Neurosurgery (Cochrane) have a special interest and expertise in correcting spinal cord and lower brain compression. This special interest involves patients with Morquio's syndrome, achondroplasia and other forms of osteodysplasia.

    My current projects include:

    • Development of a systematic patient prioritization and scheduling tool
    • Children's cancer: access to care - surgical services prioritization
    • The determinants of health in children with hydrocephalus
    Selected Publications

    Das S, Yip S, Hukin J, Cochrane D, Dunham C. 2014. Pleomorphic xanthoastrocytoma of the spinal cord: Case report and literature review. Clin Neuropathol 33(3):190-6.PMID: 24495348. DOI: 10.5414/NP300689.

    Carreras EM, Lyons CJ, Cochrane DD. 2014. Delayed visual loss from optochiasmatic arachnoiditis after resection of craniopharyngioma. J Neurosurg Pediatr 13(5):520-4. PMID: 24606404. DOI: 10.3171/2014.2.PEDS13530.

    Glass T, Cochrane DD, Rassekh SR, Goddard K, Hukin J. 2014. Growing teratoma syndrome in intracranial non-germinomatous germ cell tumors (iNGGCTs): A risk for secondary malignant transformation-a report of two cases. Childs Nerv Syst 30(5):953-7. PMID: 24122016. DOI: 10.1007/s00381-013-2295-1.

    Woerdeman PA and Cochrane DD. 2014. Disruption of silicone valve housing in a codman hakim precision valve with integrated siphonguard. J Neurosurg Pediatr 13(5):532-5. PMID: 24635137. DOI: 10.3171/2014.2.PEDS13436.

    Muniak AM, Cochrane DD, Dijk Mv, Hamilton A, Schwarz SK, O'Connor JP, Sahjpaul RL. 2014. What would I want for my surgery? Healthc Q 17(4):7-9. PMID: 25906457.

    Cochrane DD, King C, Beauchamp R, MacNeily A.: Spasticity in Spina Bifida. In: Ozek M, Cinalli G, Maixner WJ, eds. The Spina Bifida: Management and Outcome. Verlag Springer, Milan, May 2008. Ch 24,p.281-95.

    Singhal A, Cochrane DD.: Optic nerve sheath fenestration and bilateral expansile cranioplasty for raised intracranial pressure in craniometaphyseal dysplasia: a case report. Childs Nerv Syst. 2008 Apr;24(4):521-4. PMID: 18205007.

    Steinbok P, Heran N, Hicdonmez H, Cochrane DD, Price A. Minimizing blood transfusions in the surgical correction of coronal and metopic craniosynostosis. Child's Nerv Syst 2004: 20:445-452. PMID: 15168053.

    Heran N, Steinbok P, Cochrane D. Conservative Neurosurgical Management of Intracranial Epidural Abscesses in Children. Neurosurgery 2003. 553:893-7. PMID: 14519222.

    Kestle JR, Drake JM, Cochrane DD, Milner R, Walker ML, Abbott R 3rd, Boop FA; Endoscopic Shunt Insertion Trial participants. Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial. J Neurosurg. 2003 Feb: 98:284-90. PMID: 12593612.

    Cochrane D, Kestle J. The influence of surgical operative experience on the duration of first ventriculoperitoneal shunt function and infection. Pediatr Neurosurg 2003: 32:295-301. PMID: 12759508.

    Steinbok P, Cochrane DD, Perrin R, Price A. Mutism after Posterior Fossa Tumor Resection in Children: Incomplete Recovery on Long-term Follow-up. Pediatr Neurosurg 2003: 39:179-183. PMID: 12944697.

    Cochrane DD, Kestle J. Ventricular Shunting for Hydrocephalus in Children: Patients, Procedures, Surgeons and Institutions in English Canada, 1989-2001. Eur J Pediatr Surg 2002: 12:S6-S11. PMID: 12541207.

    Steinbok P, Hentschel S, Almqvist P, Cochrane DD, Poskitt K. Management of optic chiasmatic hypothalamic astrocytomas in children. Canadian Journal of Neurological Sciences 29:132-138, 2002.

    Garton HJL, Kestle JRW, Cochrane DD, Steinbok P. A cost effectiveness analysis of endoscopic third ventriculostomy. Neurosurgery. 2002 51:69-77.

    Hentschel S, Steinbok P, Cochrane DD, Kestle J. Reduction of transfusion rates in the surgical correction of sagittal synostosis. J Neurosurgery 2002; 97:503-509. PMID: 12182437.

    Cochrane DD, Finley C, Kestle J, Steinbok P. The patterns of late deterioration in patients with transitional lipomyelomeningocele. Eur J Surg 2000; 10(Suppl I): 13-17. PMID: 11214824.

    Honours & Awards
    Research Group Members

    Data management committee, International Infant Hydrocephalus Study
    Outcome review committee, Management of Myelomeningocele Study

    Canadian Pediatric Neurosurgery Study Group

    MFMU Network/MOMS Advisory Board