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Developmental Anatomy and Physiology of the Central Nervous System in Children

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Fundamentals of Pediatric Neuroanesthesia

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Abstract

The pediatric age group includes a wide spectrum ranging from neonates, infants to adolescents, each group having unique physiology to understand. Due to the anatomical, physiological, and pathological differences, children present as a heterogeneous group, especially during the first 8 years of life. The nervous system of children is profoundly different during the various stages of childhood and from adults. The central nervous system (CNS) is incompletely developed at birth and continues to grow and mature till the second year of life. The proportion of cerebral blood flow is highest in children between 1 and 3 years, about 40–50% of the cardiac output, increasing their vulnerability to cerebral ischemia during periods of systemic hypotension. Though cerebral autoregulation and CO2 reactivity are preserved even in preterm and term neonates, their immature neurons are extremely vulnerable to adverse events like sudden physiological perturbations and the influences of toxic substances. This warrants the need to maintain homeostasis as closely as possible and the institution of neuroprotective strategies and treatment. Sound knowledge of the unique neurodevelopmental events and neurophysiological principles applicable to the pediatric population is paramount for the safe and effective perioperative care of infants and children at risk for neurological injury.

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Acknowledgments

We would like to thank Mr. Mohammed Haroon A., Anesthesia Technician, Diploma in Anesthesia and Critical Care Technology, Aniketh Prabhu K, Year 1 Medical Student, CMC Vellore, and Balaji Balasubramanian, CEO, Dot Imagine institute of Art for their artwork.

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  1. Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    Vanitha Rajagopalan

  2. Department of Neuroanaesthesia, Christian Medical College (CMC), Vellore, Tamil Nadu, India

    Ramamani Mariappan

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  1. Vanitha Rajagopalan
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  2. Ramamani Mariappan
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Correspondence to Ramamani Mariappan .

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  1. Department of Neuroanesthesiology & Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Girija Prasad Rath

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Rajagopalan, V., Mariappan, R. (2021). Developmental Anatomy and Physiology of the Central Nervous System in Children. In: Rath, G.P. (eds) Fundamentals of Pediatric Neuroanesthesia. Springer, Singapore. https://doi.org/10.1007/978-981-16-3376-8_2

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