Development in harmony

Excerpt

“Children are not little adults. Infants are not little children. Newborns are not little infants” (Anthony J. Raimondi 1972) [1]. The basic concept of this pediatric neurosurgical proverb is a fact that we pediatric neurosurgeons are always aware of. Development is the most important factor in our practice and studies. Disease involving the immature nervous system affects the neuronal maturation process in various stages, resulting in different clinical manifestations, that is, if it occurs at a very early stage, a disturbance of the formation of the central nervous system (CNS) leads to a CNS malformation. The formation disorder malformation is the morphological concept of the congenital entity, but the functional developmental disorder is the major clinical concern in postnatal diseases affecting the young brain and spinal cord. These clinical manifestations could be summarized as developmental disorders, either as a morphological or functional concept, differing from neurological deficits, which are destructive insults of the completed structure and function in the mature CNS or adults. Pediatric neurosurgery exists to correct the wrong direction or the remove the factor/lesion affecting the neuronal maturation process, whereas adult neurosurgery deals with the reconstruction procedures to regain the lost CNS function. The plasticity of the CNS may be the term for the completed brain, and it is different from the incomplete immature brain. …