Stereotactically guided transfrontal removal of intraventricular midline tumors in children. Neurosurgical and neuropsychological considerations.
Five children with supratentorial intraventricular midline cerebral tumors were operated on using a stereotactically guided transfrontal approach. Assisted by a three-dimensional graphic reconstruction of cerebral anatomy, the surgeon was able to reach and remove the lesion with minimal damage to healthy parenchyma. Neurosurgical and neuropsychological evaluation of the results suggests that this surgical approach is a valid alternative to the transcallosal route. This image-based intraoperative guidance is as effective as landmark-oriented surgery, which requires section of the corpus callosum, possibly leading to neuropsychological deficits, particularly in the pediatric age group.
Giorgi
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Department of Neurosurgery, Istituto Nazionale Neurologico C. Besta, Milan, Italy.
Riva
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D000293:Adolescent; D002551:Cerebral Ventricle Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008866:Microsurgery / Q000379:methods; D009422:Nervous System Diseases / Q000209:etiology; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D011856:Radiographic Image Enhancement; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome