Pediatric Neuroanesthesia

  • Mairead HeaneyEmail author


The child’s developing brain is relatively large and has a higher blood flow and oxygen consumption than an adult brain. It is susceptible to diffuse axonal injury and edema during head trauma. Hypotension and hypoxia may contribute to secondary injury after the trauma. Cerebral perfusion pressure is lower in younger ages, but the lowest, safe perfusion pressure is not known. Anesthetic agents cause broadly the same changes to cerebral blood flow and intracranial pressure as they do in adults. Malignant brain tumors are the second commonest cancer in children, and most occur in the posterior fossa. They often cause the triad of headache, vomiting and gait imbalance, and hydrocephalus is often present. Surgery is often performed in the prone position, and much attention is paid to prevent misplacement of the endotracheal tube during anesthesia and surgery. Neonates with lipomeningomyelocele (spina bifida) often have a Chiari malformation and hydrocephalus.


Pediatric neuroanesthesia Cerebral perfusion pressure in children Anesthesia children traumatic brain injury Anesthesia spina bifida 

Further Reading

  1. Allen B, et al. Specific cerebral perfusion pressure thresholds and survival in children and adolescents with severe traumatic brain injury. Pediatr Crit Care Med. 2014;15:62–70.CrossRefGoogle Scholar
  2. Crawford J. Pediatric brain tumors. Pediatr Rev. 2013;34:63–76. A detailed medical review of the different brain tumors in children.CrossRefGoogle Scholar
  3. Emeriaud G, Pettersen G, Ozanne B. Pediatric traumatic brain injury: an update. Curr Opin Anesthesiol. 2011;24:307–13.CrossRefGoogle Scholar
  4. Furay C, Howell T. Pediatric neuroanaesthesia. Cont Educ Anaesth Crit Care Pain. 2010;10:172–6.CrossRefGoogle Scholar
  5. Hardcastle N, Benzon HA, Vavilala MS. Update on the 2012 guidelines for the management of pediatric traumatic brain injury—information for the anesthesiologist. Pediatr Anesth. 2014;24:703–10.CrossRefGoogle Scholar
  6. McClain CD, Soriano SG. Anesthesia for intracranial surgery in infants and children. Curr Opin Anesthesiol. 2014;27:465–9.CrossRefGoogle Scholar
  7. Szabo EZ, Luginbuehl I, Bissonnette B. Impact of anesthetic agents on cerebrovascular physiology in children. Pediatr Anesth. 2009;19:108–18. A good review of the factors that affect cerebral blood flow.CrossRefGoogle Scholar
  8. Wright Z, Larrew T, Eskandari R. Pediatric hydrocephalus: current state of diagnosis and treatment. Pediatr Rev. 2016;37:478–88.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Paediatric Critical Care UnitPerth Children’s HospitalNedlandsAustralia
  2. 2.Department of Anaesthesia and Pain ManagementPerth Children’s HospitalNedlandsAustralia

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