Recent technological advances in pediatric brain tumor surgery. (January 2017)

• Record Type: Journal Article
• Authors: Zebian, Bassel; Vergani, Francesco; Lavrador, José Pedro; Mukherjee, Soumya; Kitchen, William John; Stagno, Vita; Chamilos, Christos; Pettorini, Benedetta; Mallucci, Conor
• Is Part Of: CNS oncology. Volume 6:Number 1(2017)
• Page Start: 71
• Page End: 82
• Publication Date: 2017-01
• Subjects: Brain tumor -- endoscope -- microscope -- paediatric -- technological advances; Central nervous system -- Tumors -- Periodicals; 616.99481
• DOI: 10.2217/cns-2016-0022
• Languages: English
• ISSNs: 2045-0907

Abstract

X-rays and ventriculograms were the first imaging modalities used to localize intracranial lesions including brain tumors as far back as the 1880s. Subsequent advances in preoperative radiological localization included computed tomography (CT; 1971) and MRI (1977). Since then, other imaging modalities have been developed for clinical application although none as pivotal as CT and MRI. Intraoperative technological advances include the microscope, which has allowed precise surgery under magnification and improved lighting, and the endoscope, which has improved the treatment of hydrocephalus and allowed biopsy and complete resection of intraventricular, pituitary and pineal region tumors through a minimally invasive approach. Neuronavigation, intraoperative MRI, CT and ultrasound have increased the ability of the neurosurgeon to perform safe and maximal tumor resection. This may be facilitated by the use of fluorescing agents, which help define the tumor margin, and intraoperative neurophysiological monitoring, which helps identify and protect eloquent brain.