Definition:
It is a type of surgical procedure that is carried out in children to cure brain tumors. Some of these tumors can be cancerous causing severe headache and black out. There are other types of brain tumors that are categorized into being non-cancerous, primary and metastic (staring in other part of body and spreading to brain). Though these tumors have surgical treatments; but they vary in pediatric patients according to the cell type, level of tumor and location in the brain. Tumors, generally, develop due to building up of extra tissue or fluid in the brain. This leads to blockage of ventricles that drain cerebrospinal fluid, which puts pressure in the brain.
The surgery is considered as a perfect option for removing all or a part of tumor to relieve pain. At first, the child is given general anesthesia and the doctor makes a flap in the skull. After this step, a stereotactic navigation system is used to check the location of the tumor. Then, your neurosurgeon will use surgical laser to vaporize as much tumor as possible. The surgeon might also use ultrasound aspirator to convert a solid tumor into liquid. By doing so, he will be able to take out maximum amount of tumor in suction. Sometimes, the doctor might take out a part of tumor to do a biopsy. This will help him to evaluate that the tumor is cancerous or not. On completing this process, the flap is replaced.
Purpose:
Pediatric neurosurgery is done to remove the tumor in the brain and relieve the patient from pain. The tumor can be classified as follows:
- Medulloblastomas: It is a malignant tumor that of the central nervous system, located in the cerebellum. The main cause of this tumor is immature neuronal precursor cell.
- Astrocytomas: It is the tumor of cerebellum and is found in the brainstem around cerebellum. They arise from glial cells and can be low grade or high grade tumors.
- Ependymomas: This starts in the cells that line the concave cavities within the brain filled with cerebrospinal fluid. In children, they are more usually found in the posterior fossa and spinal cord.
- Craniopharyngiomas: They commonly occur just above the pituitary gland. These glands are located at the bottom of the brain behind the optic nerves. It controls many important hormonal functions. This type of tumor can squeeze the nearby structures that cause vision and memory loss.
Precautions:
After the surgery is done, your doctor will ask you to avoid driving and operating electronic equipment. You will also be asked to shun alcohol intake and showering your hairs for few days. You doctor will ask you to keep away from getting your hair stylized. Apart from this, you will also be asked to stay away from doing any strenuous work that puts pressure on brain.
Pre and Post Care:
The first step in pre-operative care is the physical examination carried out by your physician. You will have to undergo neurological exam including test for muscle strength, eye and mouth movement. Some other tests consist of CT (Computerized Tomography) scan, MRI (Magnetic Resonance Imaging), bone x-ray and Myelogram (Spinal x-ray). You will also be given blood thinners to avoid blood clots. The doctor will not allow you to eat or drink one midnight prior to your surgery.
Your surgeon will give you pain relieving medication after completing the surgery. The children should be encourages to resume normal physical activities, as much as they can tolerate. Along with these after care measures, you will have to go for regular medical check-ups for monitoring the healing process.
Risk Factors:
Though this surgery is essential for removing maximum or complete tumor; still, it has risk factors that cannot be avoided.
- Loss of speech
- Balance difficulties
- Hormonal disorders
- Delay in the development of body
- Bleeding
- Swelling in brain
Hospital Stay:
For the entire pediatric neurosurgical program, including examination and tests, you will be required to stay in the hospital for 1 week to 10 days.
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