Pediatric Intracranial Tumor Surgery [Neurosurgery Wiki]

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====== Pediatric Intracranial Tumor Surgery ======

Pediatric [[Brain Tumor Surgery]]

Pediatric [[Intracranial Tumor Surgery]]: Overview
🔬 Epidemiology
Brain tumors are the most common solid tumors in children and the leading cause of cancer-related death.

see [[Posterior fossa tumor surgery]]

Common types:

[[Medulloblastoma surgery]]

[[Pilocytic astrocytoma surgery]]

Ependymoma

Diffuse intrinsic pontine glioma (DIPG)

Craniopharyngioma

===== 🧠 Surgical Goals =====

Histological diagnosis: Confirm tumor type.

Maximal safe resection: Aim for gross total resection (GTR) where feasible.

CSF diversion: Treat hydrocephalus if present (e.g., EVD, VP shunt, ETV).

===== 🧰 Preoperative Planning =====

MRI with contrast (brain + spine if medulloblastoma is suspected).

Neuronavigation, DTI (for eloquent areas), fMRI if age-appropriate.

Multidisciplinary board decision.

===== 🛠️ Surgical Techniques =====

Use of intraoperative MRI, neurophysiological monitoring, and ultrasound.

Microsurgical techniques via craniotomy or endoscopic approaches, depending on tumor location.

===== ⚠️ Complications =====

Neurological deficits (motor, visual, cognitive)

CSF leak, infection, hydrocephalus

Endocrinological disorders (especially for hypothalamic/pituitary tumors)

Posterior fossa syndrome (especially post-medulloblastoma)

===== 🔄 Postoperative Management =====

Early MRI to evaluate extent of resection.

Multimodal adjuvant therapy (chemo/radio depending on histology).

Neurorehabilitation and neuropsychological support.

===== 🧑‍⚕️ Multidisciplinary Follow-Up =====

Pediatric neuro-oncology

Endocrinology, rehabilitation, neurology, neuropsychology

Long-term surveillance for recurrence and late effects