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Child's Nervous System
Published in: Child's Nervous System 10/2015

Open Access 01-10-2015 | Special Annual Issue

Surgical approaches for brainstem tumors in pediatric patients

Authors: Sergio Cavalheiro, Kaan Yagmurlu, Marcos Devanir Silva da Costa, Jardel Mendonça Nicácio, Thiago Pereira Rodrigues, Feres Chaddad-Neto, Albert L. Rhoton

Published in: Child's Nervous System | Issue 10/2015

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Abstract

Purpose

To analyze the pathways to brainstem tumors in childhood, as well as safe entry zones.

Method

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.

Results

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 %.

Conclusions

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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Metadata
Title
Surgical approaches for brainstem tumors in pediatric patients
Authors
Sergio Cavalheiro
Kaan Yagmurlu
Marcos Devanir Silva da Costa
Jardel Mendonça Nicácio
Thiago Pereira Rodrigues
Feres Chaddad-Neto
Albert L. Rhoton
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 10/2015
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-015-2799-y

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