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Pediatric Neurosurgery PowerPoint Presentation

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Description : Check out this medical presentation on astrocytoma in childhood, which is titled "Pediatric Neurosurgery", to know about pediatric neurosurgery and the entire spectrum of neurosurgical subspecialties.

Tags : astrocytoma, childhood, Pediatric Neurosurgery, Brain tumors, Hydrocephalus, Ependymoma, Spina bifida, spinal dysraphism, Myelomeningocele, Epilepsy Surgery

Published on : May 10, 2021 | Views : 3019 | Downloads : 0

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Slide 1-

Introduction to Neurosurgical Subspecialties: Pediatric Neurosurgery Brian L. Hoh, MD1 and Gregory J. Zipfel, MD2 1University of Florida, 2Washington University
Slide 2-

Pediatric Neurosurgery Pediatric neurosurgeons treat children with: Brain tumors Spina bifida / spinal dysraphism Spasticity Brachial plexus injury Hydrocephalus Epilepsy Spinal deformities / tumors Brain and spine trauma Pediatric neurosurgery crosses the entire spectrum of neurosurgical subspecialties
Slide 3-

Fellowship for pediatric neurosurgery is typically required Pediatric Neurosurgery
Slide 4-

Hydrocephalus Causes: Communicating Idiopathic, post-hemorrhagic, post-infectious, congenital Obstructive Tumors, cysts, aqueductal stenosis, ventricular loculations
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Hydrocephalus Treatment: Ventriculoperitoneal Shunt
Slide 6-

Hydrocephalus Treatment: Endoscopic Third Ventriculostomy (ETV) ETV
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Brain tumor Infratentorial (2/3) Medulloblastoma -- malignant Juvenile pilocytic astrocytoma (JPA) -- benign Ependymoma – benign or malignant Brainstem tumors – benign or malignant Atypical teratoid rhabdoid tumor (ATRT) -- malignant Supratentorial (1/3) JPA Ependymoma Glioma/astrocytoma Ganglioglioma, Dysembryoplastic NeuroEpithelial Tumor (DNET) Craniopharyngioma Many others
Slide 8-

Brain Tumors--Astrocytoma Pre-op Post-op
Slide 9-

Brain Tumors--Ependymoma Pre-op Post-op
Slide 10-

Spina bifida/spinal dysraphism Closed neural tube defects Tethered spinal cord fatty filum, dermal sinus tract, diastematomyelia, lipomyelomeningocele Open neural tube defects Myelomeningocele and variants (myelocystocele) Associated with hydrocephalus, type II Chiari malformation, syringomyelia, urologic and orthopedic disorders
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Dermal sinus tract with tethered cord
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Myelomeningocele / NTD
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Epilepsy Surgery Epilepsy is predominantly a disease of the young Majority of patients have seizure onset in childhood Substrates include cortical dysplasia/neuronal migrational disorders, tuberous sclerosis, lesional/structural causes such as tumors, vascular lesions, trauma, stroke
Slide 14-

Response to AEDs among children (AED = anti-epileptic drug) 1st AED 60-70% Seizure-Free 2nd AED 20-30% Seizure-Free 3rd AED 5-10% Seizure-Free Stage I pre-surgical evaluation EEG-video, MRI, PET, Neuropsychology Epilepsy Surgery Conference
Slide 15-

Lesionectomy 6 mo old with partial seizures Focal Cortical Dysplasia
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Peri-insular Hemispherotomy 7 year old with intractable seizures
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Chiari malformation Type I is most common Herniation of hindbrain (cerebellar tonsils) into upper cervical canal Usually asymptomatic Associated with suboccipital post-tussive headache Syringomyelia and scoliosis Posterior decompression +/- duraplasty are main surgical options Type II associated with myelomeningocele only
Slide 18-

Suboccipital craniectomy / duroplasty for Type 1 Chiari with syrinx
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Craniosynostosis Affects 1:2500 children Premature fusion of one or more cranial vault sutures Sagittal most common, followed by metopic/coronal and then lamboid Not to be confused with benign positional plagiocephaly Surgical options include traditional open vault and facial reconstructions and minimally invasive endoscopic strip craniectomies with custom molding helmet therapy for children < 6 months of age
Slide 20-

Craniosynostosis Open Surgery Endoscopic Surgery
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Conclusions Pediatric neurosurgeons do procedures that span the spectrum of neurosurgical operations Even more than adult neurosurgery, pediatric neurosurgeons have ”families as patients”