Abstract
For the majority of brain tumors in children, the extent of resection is the most important factor predicting long-term outcome. This conclusion has led many neurosurgeons to be as aggressive as possible during the initial surgical procedure in an effort to achieve gross total resection (GTR; Pollack 1999; Albright et al. 2000). It should be recognized that GTR is not the primary goal for tumors where sensitivity to adjuvant therapy is high (e.g., germinoma), or where there is clear extension into eloquent regions (e.g., brainstem and thalamic glioma). Fortunately, these latter groups represent a minority of pediatric brain tumors (Pollack 1994).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Aguiar PH, Plese JP, Ciquini O et al (1995) Transient mutism following a posterior fossa approach to cerebellar tumors in children: a critical review of the literature. Childs Nery Syst 11: 306–310
Albright AL, Pollack IF, Adelson PD (eds) (2001) Operative techniques in pediatric neurosurgery. Thieme, New York
Albright AL, Sposto R, Holmes E et al (2000) Correlation of neurosurgical subspecialization with outcomes in children with malignant brain tumors. Neurosurgery 47:879–885; discussion 885–887
Berger MS, Ojemann GA (1992) Intraoperative brain mapping techniques in neuro-oncology. Stereotact Funct Neurosurg 58: 153–161
Berger MS, Baumeister B, Geyer JR et al (1991) The risks of metastases from shunting in children with primary central nervous system tumors. J Neurosurg 74: 872–877
Catsman-Berrevoets CE, van Dongen HR, Mulder PG et al (1999) Tumour type and size are high risk factors for the syndrome of “cerebellar” mutism and subsequent dysarthria. J Neurol Neurosurg Psychiatry 67:755–757
Chitoku S, Otsubo H, Harada Y et al (2001) Extraoperative cortical stimulation of motor function in children. Pediatr Neurol 24: 344–350
Chuang SH, Otsubo H, Hwang P et al (1995) Pediatric magnet- ic source imaging. Neuroimaging Clin North Am 5:289–303 Cochrane DD, Gustaysson B, Poskitt KP et al (1994) The surgi- cal and natural morbidity of aggressive resection for poste- rior fossa tumors in childhood. Pediatr Neurosurg 20: 19–29
Doxey D, Bruce I), Sklar, F et al (1999) Posterior fossa syndrome: identifiable risk factors and irreversible complications. Pediatr Neurosurg 31: 131–136
Ersahin Y (1998) Transient cerebellar mutism. Childs Nery Syst 14: 687
Ersahin Y, Mutluer S, Cagli Set al (1996) Cerebellar mutism: report of seven cases and review of the literature. Neurosurgery 38: 60–65
Fahlbusch R, Ganslandt O, Nimsky C (2000) Intraoperative imaging with open magnetic resonance imaging and neuronavigation. Childs Nery Syst 16: 829–831
Foreman NK, Love S, Gill SS et al (1997) Second-look surgery for incompletely resected fourth ventricle ependymomas: technical case report. Neurosurgery 4o: 856–86o
Friedman JA, Lynch JJ, Buckner JC et al (2001) Management of malignant pineal germ cell tumors with residual mature teratoma. Neurosurgery 48: 518–522
Gjerris F,Agerlin N, Borgesen SE et al (1998) Epidemiology and prognosis in children treated for intracranial tumours in Denmark 196o-1984. Childs Nery Syst 14: 302–311
Gleason PL, Kikinis R, Altobelli D et al (1994) Video registration virtual reality for nonlinkage stereotactic surgery. Stereotact Funct Neurosurg 63: 139–143
Gnanalingham KK, Lafuente J, Thompaon D et al (2002) Surgical procedures for posterior fossa tumors in children: does craniotomy lead to fewer complications than craniectomy? J Neurosurg 97: 821–826
Grabb PA, Albright AL, Sclabassi RJ et al (1997) Continuous intraoperative electromyographic monitoring of cranial nerves during resection of fourth ventricular tumors in children. J Neurosurg 86: 1–4
Haglund MM, Berger MS, Shamseldin M et al (1994) Cortical localization of temporal lobe language sites in patients with gliomas. Neurosurgery 34: 567–576
Hennessy MJ, Elwes RD, Honavar M et al (2001) Predictors of outcome and pathological considerations in the surgical treatment of intractable epilepsy associated with temporal lobe lesions. J Neurol Neurosurg Psychiatry 7o:45o-458
Hoppe-Hirsch E, Brunet L, Laroussinie F et al (1995) Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery. Childs Nery Syst 11:340-345
Imielinski BL, Kloc W, Wasilewski W et al (1998) Posterior fossa tumors in children-indications for ventricular drainage and for V-P shunting. Childs Nery Syst 14: 227–229
Kaplan AM, Bandy DJ, Manwaring KH et al (1999) Functional brain mapping using positron emission tomography scanning in preoperative neurosurgical planning for pediatric brain tumors. J Neurosurg 91: 797–803
Keles GE, Lamborn KR, Berger MS (2001) Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. J Neurosurg 95: 735–745
Khan RB, Sanford RA, Kun LE et al (2001) Morbidity of second-look surgery in pediatric central nervous system tumors. Pediatr Neurosurg 35: 225–229
Kumar V, Phipps K, Harkness W et al (1996) Ventriculo-peritoneal shunt requirement in children with posterior fossa tumours: an 11-year audit. Br J Neurosurg 10: 467–470
Lam CH, Hall WA, Truwit CL et al (2001) Intra-operative MRIguided approaches to the pediatric posterior fossa tumors. Pediatr Neurosurg 34: 295–300
Leblanc R, Meyer E(199o) Functional PET scanning in the assessment of cerebral arteriovenous malformations. Case report. J Neurosurg 73: 615–619
Leblanc R, Meyer E, Bub D et al (1992) Language localization with activation positron emission tomography scanning. Neurosurgery 31: 369–373
Levisohn L, Cronin-Golomb A, Schmahmann JD (2000) Neuropsychological consequences of cerebellar tumour resection in children: cerebellar cognitive affective syndrome in a paediatric population. Brain 123x041–1050
Mosewich RK, So EL, O’Brien TJ et al (2000) Factors predictive of the outcome of frontal lobe epilepsy surgery. Epilepsia 41:843–849
Ojemann SG, Berger MS, Lettich E et al (2003) Localization of language function in children: results of electrical stimulation mapping. J Neurosurg 98: 465–470
Otsubo H, Ochi A, Elliott I et al (2001) MEG predicts epileptic zone in lesional extrahippocampal epilepsy: 12 pediatric surgery cases. Epilepsia 42: 1523–1530
Penfield W, Boldrey E(1937) Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain 60: 389–443
Pollack IF (1994) Brain tumors in children. N Engl J Med 331: 1500–1507
Pollack IF (1999) The role of surgery in pediatric gliomas. J Neurooncol 42:271–288
Pollack IF, Polinko P, Albright AL et al (1995) Mutism and pseudobulbar symptoms after resection of posterior fossa tumors in children: incidence and pathophysiology. Neurosurgery 37: 885–893
Regelsberger J, Lohmann F, Helmke K et al (2000) Ultrasound-guided surgery of deep seated brain lesions. Eur J Ultrasound 12: 115–121
Sainte-Rose C, Cinalli G, Roux FE et al (2001) Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg 95: 791–797
Schiffbauer H, Ferrari P, Rowley HA et al (2001) Functional activity within brain tumors: a magnetic source imaging study. Neurosurgery 49x313–1320
Schneider JP, Schulz T, Schmidt F et al (2001) Gross-total surgery of supratentorial low-grade gliomas under intraoperative MR guidance. AJNR Am J Neuroradiol 22: 89–98
Sekiya T, Hatayama T, Shimamura N et al (2000) Intraoperative electrophysiological monitoring of oculomotor nuclei and their intramedullary tracts during midbrain tumor surgery. Neurosurgery 47: 1170–1166
Steinbok P, Mutat A (1999) Cerebellar astrocytoma. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and practice of pediatric neurosurgery. Thieme, New York, p 1300
Weiner HL, Finlay JL (1999) Surgery in the management of primary intracranial germ cell tumors. Childs Nery Syst 15: 770–773
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2004 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Gupta, N., Perry, V., Berger, M.S. (2004). Current Surgical Management. In: Gupta, N., Banerjee, A., Haas-Kogan, D. (eds) Pediatric CNS Tumors. Pediatric Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09227-9_14
Download citation
DOI: https://doi.org/10.1007/978-3-662-09227-9_14
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-05554-6
Online ISBN: 978-3-662-09227-9
eBook Packages: Springer Book Archive