Frame-based stereotactic neurosurgery in children under the age of seven: Freiburg University's experience from 99 consecutive cases

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art_FURLANETTI_Framebased_stereotactic_neurosurgery_in_children_under_the_age_2015.PDF (1.34 MB)
Citações na Scopus
17
Tipo de produção
article
Data de publicação
2015
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE BV
Autores
FURLANETTI, Luciano L.
CORDEIRO, Joacir G.
TRIPPEL, Michael
Citação
CLINICAL NEUROLOGY AND NEUROSURGERY, v.130, p.42-47, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Introduction: Stereotactic frame-based procedures proved to be precise, safe and are of widespread use among adult patients. Regarding pediatric patients few data is available, therefore the use of the stereotactic frame remains controversial in this population. This motivated us to report our experience in stereotactic procedures in the youngest patients and review the literature concerning this subject. Methods: All frame-based procedures performed in patients younger than seven years in the University of Freiburg during the last 10 years were retrospectively analyzed and discussed under the light of the current literature. Results: The studied population was composed of 72 patients under the age of seven (mean 3.4 +/- 2.1 years-old), in whom 99 stereotactic procedures were performed. Brain tumor was present in 60 patients, hydrocephalus in five, cystic lesions in three, intracranial abscess in three and epilepsy in one patient. Stereotactic surgery was performed in 36 cases for brachytherapy, in 29 for biopsy, in 20 cases for cyst puncture, in eight for stereotactically guided endoscopic ventriculostomy, in five for catheter placement and in one case for depth electrode insertion. The overall complication rate was 5%. There were three cases of pin penetration through the skull, one case of frame dislocation after extensive cyst drainage and two skull fractures. Neurologic deficit related to frame fixation was observed in none of the cases. In disagreement with other authors, no case of pin related infection, air embolism, hematoma or CSF leak was observed. Conclusion: Frame-based stereotactic neurosurgery is a safe technique also in the youngest patients. Rather than the simple use of torque-limiting devices training and experience in the manual adjustment of the stereotactic frame in children have been proven to be crucial factors that contribute to reducing pin related complications.
Palavras-chave
Frame-based stereotaxy, Pediatric neurosurgery, Skull Pins, Safety
URI
https://observatorio.fm.usp.br/handle/OPI/9627
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Coleções
Artigos e Materiais de Revistas Científicas - LIM/45
Artigos e Materiais de Revistas Científicas - HC/ICHC