Pediatric Neurosurgery

Pediatric Neurosurgery:

Any serious illness that befalls a child causes enormous emotional and physical strain, both for the child and the family. A variety of neurological disorders involving brain and spinal cord are there in children which need surgical intervention.

A few common disorders in children needing surgical intervention are :

• Congenital hydrocephalus
• Hydrocephalus secondary to infection ,bleeding or tumors
• Craniosynostosis &Craniofacial disorders
• Congenital disorders of the spine, including spina bifida and tethered spinal cords.
• Invasive conditions like pediatric brain, spinal cord and peripheral nerve tumors.
• Trauma, such as head injuries.

 

Surgery for Pediatric disorders :

 

• Surgery for hydrocephalus : Hydrocephalus is one of the most prevalent childhood disorder needing surgery in the form of CSF diversion ,sometimes as an emergency procedure also to save patient’s life. Two kind of surgeries are offered to patients.
  1. VP shunt
  2. Endoscopic third ventriculostomy

 

• Surgery for craniosynostosis and craniofacial disorders : Craniofacial disorders may alter your child's appearance and lead to medical and 
• developmental problems. In collaboration with plastic surgeons,these disorders can be treated ,prevent various associated medical problems and offer a better cosmetic appearance. They are operated by both open and endoscopic approaches.

• Surgery for congenital brain and spine malformations: Congenital central nervous system abnormalities, such as Chiari malformations ,arachnoid cysts, neural tube defects and tethered spinal cords can affect your child's health and quality of life. An early timely done surgery for these disorders can lead to better health of the child.

 

1. Arachnoid cysts are the fluid filled spaces in brain which may need surgery if it causes severe headache,seizures or focal deficits. Surgery can be done with microscope or endoscope with minimal invasive approach.

2. Chiari malformation is a structural problem in the back of the head and in neck. It occurs when part of the brain called the cerebellar tonsil pushes through an opening at the base of the skull into the spinal canal. This abnormal position may result in blockage of outflow of csf, putting pressure on the brain and spinal cord, ans causes problems like headaches, difficulty swallowing, dizziness and problems with speech and movement and paralysis in severe cases.

Traditionally, treatment involves surgery to remove the covering of the brainand upper spinal cord   to allow more room to accommodate the malformation.

 

3. Neural tube defects and tethered cord syndromes: Neural tube defects are present in a child since birth.

 

Types of neural tube defects include:

• Myelomeningocele: If a portion of the spine and spinal cord did not form appropriately and there is associated abnormality of the overlying skin,then the child is born with a swelling in the back. It may be associated with weakness of limbs and bladder bowel incontinence. , The  child may need urgent surgery after birth to fix it. Some children may develop

 

complications, such as a tethered spinal cord, which may require additional procedures to repair.   

• Encephalocele: Gaps in the skull that allow brain tissue to protrude out , forming a small sac that pushes out from the head. Encephaloceles require surgical correction to prevent further damage.  
• Spina bifida: The spine and tissue surrounding the spinal cord do not fully develop before birth and may need surgery.

 

Surgery for brain tumors : A variety of tumors can occur in infants and children like gliomas,embryonal tumors,craniopharyngioma,glioneural tumors,choroid plexus tumors,schwannoma etc.

Depending on the location of tumors,either microscopic or endoscopic approach can be used to operate these tumors.

Category:Pediatric Neurosurgery