Evaluation Of The Paediatric Neurosurgical Patient

2160 WordsMay 20, 20169 Pages
Key Points 1. Approach to the paediatric neurosurgical patient is different because of age-related changes in neurophysiology and cranial development. 2. The signs and symptoms of raised intracranial pressure in paediatric neurosurgical cases are age specific. 3. Blood loss due to surgery or tumor bleed into the cavity constitutes a major fraction of total blood volume in the paediatric population. 4. Capnography is the most feasible and safer method to monitor venous air embolism in children. Introduction The majority of tumors (60-70%) in pediatric age group occur in the posterior fossa. The reason behind propensity to occur in the posterior fossa has not been elucidated till date. Lesion in the posterior fossa may be neoplastic, developmental and vascular processes requiring surgical intervention. By far, the most common posterior fossa tumors of childhood are medulloblastomas, ependymomas and astrocytomas. Medulloblastomas are the most common malignant brain tumor in children comprising 20% to 25% of all pediatric brain tumors. The median age at diagnosis is approximately 6 to 9 years. Most of tumors occur in midline and frequently found associated with hydrocephalus. Success with surgical intervention has become possible because of improved understanding of physiology, advances in imaging and microsurgical techniques, excellent anaesthetic techniques available, advances in perioperative care of the patient. These in turn have improved the survival and quality of

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