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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