Abstract
PurposeTo analyze the pathways to brainstem tumors in childhood, as well as safe entry zones.MethodWe conducted a retrospective study of 207 patients less than 18 years old who underwent brainstem tumor resection by the first author (Cavalheiro, S.) at the Neurosurgical Service and Pediatric Oncology Institute of the São Paulo Federal University from 1991 to 2011.ResultsBrainstem tumors corresponded to 9.1 % of all pediatric tumors operated in that same period. Eleven previously described “safe entry zones” were used. We describe a new safe zone located in the superior ventral pons, which we named supratrigeminal approach. The operative mortality seen in the first 2 months after surgery was 1.9 % (four patients), and the morbidity rate was 21.2 %.ConclusionsAnatomic knowledge of intrinsic and extrinsic brainstem structures, in association with a refined neurosurgical technique assisted by intraoperative monitoring, and surgical planning based on magnetic resonance imaging (MRI) and tractography have allowed for wide resection of brainstem lesions with low mortality and acceptable morbidity rates.
Highlights
The brainstem is one of the most complex structures in the human body and contains the most complex intracranial anatomy [55]
Several articles have been published on brainstem anatomy and Bsafe entry zones.^ Most of these are related to cavernoma surgery and few are related to brainstem tumor surgical approaches in children [9, 19, 22, 26, 53]
The aim of this study was to review the described surgical approaches and those conducted by the first author (Cavalheiro, S.) of this article on the basis of 207 patients aged less than 18 years who underwent brainstem tumor surgery
Summary
The brainstem is one of the most complex structures in the human body and contains the most complex intracranial anatomy [55]. This compact, midline organ is protected anteriorly by the clivus, laterally by the petrous part of temporal bone, superiorly by the diencephalon, and posteriorly by the cerebellum. The aim of this study was to review the described surgical approaches and those conducted by the first author (Cavalheiro, S.) of this article on the basis of 207 patients aged less than 18 years who underwent brainstem tumor surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
