About

David H. Harter, MD, is a neurosurgeon at NYU Langone who provides compassionate and comprehensive care to both adult and pediatric patients. His clinical focus includes treating a wide range of neurosurgical disorders affecting the brain, spinal cord, spine, and skull, with particular expertise in congenital conditions such as hydrocephalus, Chiari malformation–syringomyelia, craniosynostosis, arteriovenous malformation, selective dorsal rhizotomy for spasticity, and pediatric brain tumors. With over 20 years of experience, he is dedicated to developing individualized treatment plans that maximize outcomes while minimizing the impact on patients' development, educational, and professional goals. Dr. Harter emphasizes understanding patients' personal goals, aspirations, and activities to foster trust and rapport, ensuring they feel supported throughout their care journey. He is actively involved in research, contributing to cooperative studies on congenital neurosurgical conditions, pediatric brain tumors, epilepsy, and spinal disorders, and his work has been recognized by organizations such as the Hydrocephalus Association and MyFace. Dr. Harter holds several leadership positions, including Director of the Pediatric Neurosurgery Fellowship Program and Director of the Division of Pediatric Neurosurgery at NYU Langone.

Research topics

• Medicine
• Bioinformatics
• Pathology
• Biology
• Internal medicine
• Genetics

Selected publications

• Developing a core outcome set for the NeuroPoint Alliance Quality Outcomes Database Pediatric Tumor Surgery Registry: a modified Delphi study

  Journal of Neuro-Oncology · 2026-05-01

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• 391 Pre-treatment Monocytosis in Pediatric Gliomas With Histone H3K27M Mutation

  Neurosurgery · 2026-03-26

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• 384 Comparative Efficacy of Perioperative Blood Conservation Agents in Pediatric Cranial Vault Remodeling: A Systematic Review and Network Meta-analysis

  Neurosurgery · 2026-03-26

  articleSenior author
  PublisherDOI

• Factors affecting infection risk and revision rates in shunted pediatric hydrocephalus: 10 years of data from a single academic center

  Child s Nervous System · 2025-10-21 · 1 citations

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• Comparative Efficacy of Perioperative Blood Conservation Agents in Pediatric Cranial Vault Remodeling: A Systematic Review and Network Meta-Analysis

  Neurosurgery · 2025-10-15

  reviewSenior author

  BACKGROUND AND OBJECTIVES: Red blood cell transfusions are commonly required in pediatric cranial vault remodeling (CVR); however, they carry risks and potential complications. This study evaluates the evidence on perioperative blood conservation agents assessing their efficacy in optimizing and reducing transfusion requirements in CVR. METHODS: A systematic review was conducted using PubMed/MEDLINE, Scopus, Embase, Web of Sciences, and Google Scholar according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to assess articles discussing blood conservation agents in pediatric CVR. A network meta-analysis compared the effectiveness of different agents including tranexamic acid (TXA), aminocaproic acid (ACA), aprotinin, erythropoietin (EPO), and iron. RESULTS: Sixteen studies analyzing 1072 patients with a mean age of 15.6 months and weight of 8.78 kg were included. The most reported craniosynostosis subtypes were sagittal (30.2%) and metopic (13.8%). TXA and ACA were independently associated with lower transfusion rates and volumes compared with placebo (ACA: odds ratio [OR], 0.25; 95% CI, 0.08-0.80; TXA: OR, 0.17; 95% CI, 0.07-0.42). Combination therapy with TXA + EPO + iron (OR: 0.004, 95% CI: 0.002-0.10) or ACA + EPO (OR: 0.04, 95% CI: 0.01-0.32) were associated with reductions in transfusion rates. Network meta-analysis ranking revealed TXA + EPO + iron (Surface Under the Cumulative Ranking [SUCRA]: 98.90%) and ACA + EPO (SUCRA: 75.41%) as the most effective treatments for reducing transfusion rates. While TXA was associated with significant reductions in blood loss compared with placebo (standard mean difference: -1.26, 95% CI: -1.97 to -0.56), ACA ranked highest for blood loss reduction (ACA: SUCRA, 84.58% vs TXA: SUCRA, 72.43%). Combination of TXA + EPO + iron was associated with significantly reduced hospital length of stay (standard mean difference: -1.00, 95% CI: -1.71 to -0.29). No treatment significantly affected the duration of surgery, and there were no reported treatment-associated thromboembolic events. CONCLUSION: Our meta-analysis reveals that TXA + ACA reduce red blood cell transfusion rates and volumes, with TXA + EPO + iron and ACA + EPO being most effective. This highlights the superiority of combination therapies and underscores the need for structured multimodal protocols in perioperative blood conservation for pediatric CVR.

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• Transoral Resection of a Symptomatic Pediatric Odontoid Process Aneurysmal Bone Cyst

  Journal of Neurological Surgery Part B Skull Base · 2025-02-01

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• Transoral resection of a symptomatic odontoid process aneurysmal bone cyst: illustrative case

  Journal of Neurosurgery Case Lessons · 2025-01-13

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  BACKGROUND: Aneurysmal bone cysts (ABCs) are slow-growing, expansile bone tumors most often observed in the long bones and lumbar and thoracic spine. Anterior column ABCs of the spine are rare, and few cases have described their surgical management, particularly for lesions with extension into the odontoid process and the bilateral C2 pedicles. In the present case, the authors describe a two-stage strategy for resection of a symptomatic 2.3 × 3.3 × 2.7-cm C2 ABC with cord compression in a 13-year-old patient. OBSERVATIONS: Initial tumor debulking was completed via a transoral approach, and resection of the involved region spanning the odontoid process to the C2-3 disc space was continued until visualization of the posterior longitudinal ligament. After appropriate decompression was confirmed, the patient was repositioned prone for removal of the residual tumor among the bilateral C2 pedicles. Posterior instrumentation was placed from the occiput to C4, with an autologous rib graft to encourage fusion. The postoperative recovery was uneventful, and 2-month imaging demonstrated postsurgical changes, resolution of compression, and a stable position of the instrumentation and graft material. LESSONS: The transoral approach facilitates sufficient exposure for the resection of large odontoid ABCs, and posterior stabilization can reduce the risk of postsurgical cervical subluxation. https://thejns.org/doi/10.3171/CASE2485.

  PublisherOA PDFDOI

• Assessment of Flexion-Extension Motion After Occipitocervical and Atlantoaxial Fusion in Children

  Neurosurgery · 2025-05-21 · 1 citations

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  BACKGROUND AND OBJECTIVES: Adult biomechanical studies suggest a significant reduction in flexion-extension motion after occipitocervical and atlantoaxial fusion. Anecdotal experience in children suggests a lower magnitude of reduction in motion after these procedures, but high-quality quantitative assessments of this motion have not yet been performed. As such, the aim of this study was to determine the magnitude of reduction in cervical spine flexion-extension after O-C2 and C1-2 fusion in pediatric patients. METHODS: The Pediatric Spine Study Group international registry was queried for patients aged 21 years or younger who underwent O-C2 or C1-2 instrumentation and fusion. Patients with cervical spine flexion-extension radiographs preoperatively and ≥6 months postoperatively were included. Flexion, extension, and overall range of motion (ROM) of the cervical spine were measured on radiographs using McGregor line and the inferior endplate of C7. RESULTS: In total, 34 patients were included, with 19 undergoing index O-C2 and 15 undergoing index C1-2 stabilization. The mean age was 9.3 ± 4.5 years with average follow-up of 3.5 ± 2.6 years. The most common etiologies were syndromic (n = 20) and congenital (n = 9). Patients undergoing O-C2 fusion had reduced neck extension (80° vs 69.6°, P = .003) and overall ROM (92.9° vs 80°, P = .002) after stabilization, but no significant reduction in flexion (-12.9° vs -10.4°, P = .324). After C1-2 fusion, there was no significant reduction in overall ROM (85.0° vs 77.5°, P = .079), extension (70.5° vs 63.4°, P = .120), or flexion (-14.6° vs -14.0°, P = .831). CONCLUSION: In this cohort, children undergoing O-C2 stabilization had a 13.9% reduction in flexion-extension motion of the cervical spine, primarily due to a reduction in extension. There may be a smaller reduction in flexion-extension motion after stabilization in children when compared with adult studies. Further studies with video analysis including axial rotation and lateral bending will be necessary to comprehensively quantify cervical spine motion after fusion across the occipitocervical and atlantoaxial junctions.

  PublisherDOI

• Complications and Long-Term Outcomes of Shunted Post-Traumatic Hydrocephalus: A Single-Center Series

  Neurotrauma Reports · 2024-05-01 · 1 citations

  articleOpen accessSenior author

  Post-traumatic hydrocephalus (PTH) is a particularly challenging complication of traumatic brain injury (TBI). The primary treatment for PTH is placement of a ventricular shunt. However, shunts are associated with high complication rates regardless of placement indication. PTH is understudied compared with other TBI sequelae, and long-term outcomes remain poorly characterized. We report our institution’s experience with shunted PTH over the last decade. Fifteen patients presented with TBI between January 2014 and April 2024 and underwent at least one shunt placement for diagnosed PTH. Patients’ demographics, injury characteristics, clinical courses, and outcomes were manually extracted from electronic medical records. Most patients were male (86.7%), White (33.3%), and suffered a severe TBI (Glasgow Coma Scale score 3–8). Four (26.7%) patients underwent shunt placement within 1 month of TBI, 9 (60.0%) within 3 months, 13 (86.7%) within 1 year, and all patients within 2 years. At least one shunt failure occurred in 53.3% of patients, and multiple failures requiring revision surgery occurred in 46.7%; all but one patient had their initial shunt failure occur within 1 year of placement. The most common reasons for shunt failure were catheter obstruction (26.3%) and infection (26.3%). Patients had a median follow-up of 2.8 years and an overall mortality rate of 13.3%. Of the surviving patients, a favorable long-term outcome (Glasgow Outcome Scale 4–5) was achieved in 26.7%. Notably, 6/15 (40.0%) patients experienced early post-traumatic seizures (ePTS). Only 4/10 patients who developed post-traumatic epilepsy (PTE) had experienced ePTS, challenging existing literature’s suggestion that ePTS most reliably predicts PTE development. Combining our cohort with that of an underrecognized report from 2000, we report a cumulative 61.9% incidence of PTE in shunt-dependent PTH, which, to our knowledge, is the highest reported incidence of PTE in current literature. The presence of shunted PTH following TBI may thus increase the risk profile for developing PTE.

  PublisherDOI

• The history of Bellevue Neurosurgery: a legacy of learning, discovery, and service

  Journal of neurosurgery · 2024-07-01

  articleSenior author

  The authors present a historical overview of NYU-Bellevue Neurosurgery, highlighting key events and influential faculty. Bellevue Hospital, the first public hospital in the US, was established in 1736 and has grown via its affiliation with New York University (now NYU Langone Health) from 1898 to the present. It maintains a strong commitment to serving disadvantaged populations of New York City and beyond. NYU-Bellevue Neurosurgery began as a department in 1951 under Dr. Thomas Hoen and has since fostered notable faculty and graduates while contributing to the development of clinical neuroscience.

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Frequent coauthors

• C. Hawkins

  University of Portsmouth

  202 shared

• James T. Rutka

  Hospital for Sick Children

  182 shared

• Stefan M. Pfister

  University Hospital Heidelberg

  182 shared

• Darell D. Bigner

  Duke University

  175 shared

• Diane K. Birks

  175 shared

• Michael Handler

  UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik

  157 shared

• N. Foreman

  150 shared

• William A. Weiss

  150 shared

Awards & honors

• Recognized by the Hydrocephalus Association and MyFace