Posterior fossa tumor resection in children: a case report and the role of intraoperative neurophysiologic monitoring

Introduction/Background: Surgery plays a crucial role in the surgical management of posterior fossa tumors in children, but maximizing the resection while preserving function remains challenging. Along with other tools available to the surgeon, intraoperative neuromonitoring aims at improving safety...

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Detalles Bibliográficos
Autores: Kondageski, Charles, Schroeder, Humberto Kluge, Mussi, Antonio Cesar de Melo, Guiotoku, Cezar Massaru, Sousa, Marcela de Moraes Barros, Nunes, Jean Costa
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Institución:Sociedade Brasileira de Neurocirurgia Pediátrica (SBNPed)
Repositorio:Archives of Pediatric Neurosurgery
Idioma:inglés
OAI Identifier:oai:ojs.www.archpedneurosurg.com.br:article/220
Acceso en línea:https://www.archpedneurosurg.com.br/sbnped2019/article/view/220
Access Level:acceso abierto
Palabra clave:posterior fossa tumors
children
medulloblastoma
intraoperative neuromonitoring
Descripción
Sumario:Introduction/Background: Surgery plays a crucial role in the surgical management of posterior fossa tumors in children, but maximizing the resection while preserving function remains challenging. Along with other tools available to the surgeon, intraoperative neuromonitoring aims at improving safety during these complex interventions. This case report highlights the role of real-time intraoperative neuromonitoring during surgery and its impact on the surgeon's decision-making process. Case report: We present the case of a 10-year-old boy with a fourth ventricle medulloblastoma, who underwent microneurosurgical resection under intraoperative neuromonitoring. The use of neurophysiological monitoring yielded relevant information during the tumor dissection of the floor of the fourth ventricle, the most crucial step of surgery, thus helping the surgeon to change tactics to minimize long-term neurological deficits. Conclusion: In combination with meticulous microneurosurgery techniques, modern anesthetic regimens, and ultrasonic aspiration, intraoperative neuromonitoring adds up to the surgeon's armamentarium for increasing safety and improving outcomes following surgery for pediatric patients bearing posterior fossa tumors.