Pediatric Neurosurgery is a subspecialty of neurosurgery. Almost all the resident doctors, trainees in neurosurgery and qualified neurosurgeons are treating the neurosurgical conditions in pediatric age group of patients. Congenital hydrocephalus,Meningocele are very common peditric neurosurgical problems. Almost all trainees and neurosurgeons are able to ventriculoperitoneal shunt surgery and excision and repair of the meningocele.
To master this subspecialty of neurosurgery one should have an overview of the common conditions which occur in neonated and children.
The management of Congenital hydrocephalus may begin in the prenatal stage. Congenital hydrocephalus or meningocele or meningomyelocele may be detected during the antenatal check up of the fetus with ultrasonography. The new born may present with the large head or a sac over the spine and ventriculoperitoneal shunt or excision and repair of meningocele may be required at birth.
Spinal dysraphism, Congenital dermal sinus, and Encephalocele are the common pediatric neurosurgical problems at birth and should further be investigated with MRI.
At later stage a child may present with hydrocphalus, brain tumors, spine tumors, infections of the brain. The presentations of such diseases are very often different from that of adults. Like incresing head size, irritability, vomiting may be the symptom oh hydrocephalus, difficulty in walking or pain during walking or difficulty in urination can be a presentation of occult spinal dysraphism. A child may lose vision even before somebody notices the symptoms of craniopharyngioma or a malignat posterior fossa tumor like edulloblastoma.
Craniosynostosis is the premature fusion of cranial sutures leading to deformed head and features of raised ICT. Oxycephaly is the fusion of all cranial sutures with rounded haed and Turricephaly is the tower like head. Plagiocephaly leads to asymmetric head size.
Craniopharyngima and pituitary tumors may present with stunted growth , visual deficits or hormonal imbalance.
Posterior fossa tumors like medulloblastoma or ependymoma may present with hydrocephalus and difficulty in walking.
Dermoid of the spine is the commonest tumor of the spine in children. The Meningomyelocele patients should also be screened for other congenital abnormalities including cranial MRI and spinal MRI for detecting hydrocephalus, Arnold Chiari Malformation, congenital dermal sinus, split cord malformations.
Endoscopic surgery has become another adjunct for comprehensive management of pediatric neurosurgical conditions , especially Endoscopic third ventriculostomy ( Hydrocephalus due to Aqueductal stenosis), & removal of intra-ventricular tumors.
So, further training in Pediatric Neurosurgery could be of great help to the Neurosurgeons to become Pediatric Neurosurgeon.
To master this subspecialty of neurosurgery one should have an overview of the common conditions which occur in neonated and children.
The management of Congenital hydrocephalus may begin in the prenatal stage. Congenital hydrocephalus or meningocele or meningomyelocele may be detected during the antenatal check up of the fetus with ultrasonography. The new born may present with the large head or a sac over the spine and ventriculoperitoneal shunt or excision and repair of meningocele may be required at birth.
Spinal dysraphism, Congenital dermal sinus, and Encephalocele are the common pediatric neurosurgical problems at birth and should further be investigated with MRI.
At later stage a child may present with hydrocphalus, brain tumors, spine tumors, infections of the brain. The presentations of such diseases are very often different from that of adults. Like incresing head size, irritability, vomiting may be the symptom oh hydrocephalus, difficulty in walking or pain during walking or difficulty in urination can be a presentation of occult spinal dysraphism. A child may lose vision even before somebody notices the symptoms of craniopharyngioma or a malignat posterior fossa tumor like edulloblastoma.
Craniosynostosis is the premature fusion of cranial sutures leading to deformed head and features of raised ICT. Oxycephaly is the fusion of all cranial sutures with rounded haed and Turricephaly is the tower like head. Plagiocephaly leads to asymmetric head size.
Craniopharyngima and pituitary tumors may present with stunted growth , visual deficits or hormonal imbalance.
Posterior fossa tumors like medulloblastoma or ependymoma may present with hydrocephalus and difficulty in walking.
Dermoid of the spine is the commonest tumor of the spine in children. The Meningomyelocele patients should also be screened for other congenital abnormalities including cranial MRI and spinal MRI for detecting hydrocephalus, Arnold Chiari Malformation, congenital dermal sinus, split cord malformations.
Endoscopic surgery has become another adjunct for comprehensive management of pediatric neurosurgical conditions , especially Endoscopic third ventriculostomy ( Hydrocephalus due to Aqueductal stenosis), & removal of intra-ventricular tumors.
So, further training in Pediatric Neurosurgery could be of great help to the Neurosurgeons to become Pediatric Neurosurgeon.
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