Surgical approaches for brainstem tumors in pediatric patients

Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery
Sergio CavalheiroAlbert L Rhoton

Abstract

To analyze the pathways to brainstem tumors in childhood, as well as safe entry zones. We conducted a retrospective study of 207 patients less than 18 years old who underwent brainstem tumor resection by the first author (Cavalheiro, S.) at the Neurosurgical Service and Pediatric Oncology Institute of the São Paulo Federal University from 1991 to 2011. Brainstem tumors corresponded to 9.1 % of all pediatric tumors operated in that same period. Eleven previously described "safe entry zones" were used. We describe a new safe zone located in the superior ventral pons, which we named supratrigeminal approach. The operative mortality seen in the first 2 months after surgery was 1.9 % (four patients), and the morbidity rate was 21.2 %. Anatomic knowledge of intrinsic and extrinsic brainstem structures, in association with a refined neurosurgical technique assisted by intraoperative monitoring, and surgical planning based on magnetic resonance imaging (MRI) and tractography have allowed for wide resection of brainstem lesions with low mortality and acceptable morbidity rates.

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Citations

Sep 24, 2016·Journal of Neurosurgery·M Yashar S KalaniRobert F Spetzler
Aug 26, 2017·Journal of Neurosurgery·Georgios Andrea ZenonosRobert Max Friedlander
Jun 30, 2018·Journal of Neurosurgery·Ali Tayebi MeybodiMichael T Lawton
Feb 7, 2019·Neurosurgical Review·Yang YangOliver Bozinov
Oct 18, 2019·Journal of Neuro-oncology·Joshua DoyleDebraj Mukherjee
Mar 17, 2020·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Tim WendeJürgen Meixensberger
Aug 10, 2017·Frontiers in Pharmacology·Wenyong LongQing Liu
Dec 22, 2019·Cancer Metastasis Reviews·Adikarige H D Silva, Kristian Aquilina
Dec 22, 2020·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Lu KongLiwei Zhang
Feb 14, 2021·Neurosurgical Review·A I CucuM D Turliuc
Nov 6, 2020·World Neurosurgery·Harrison FaulknerCharles Teo
Aug 5, 2021·Surgical Neurology International·Ayman Tarek MahmoudAhmed Mohamed Ahmed Alselisly
Oct 30, 2021·World Neurosurgery·Juan Leonardo Serrato-AvilaFeres Chaddad-Neto

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Methods Mentioned

BETA
biopsy
biopsies
dissection

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