title: Anesthesiological and intensive care considerations in children undergoing extensive cerebral excision procedure for congenital epileptogenic lesions.
abstract: BACKGROUND
  Epilepsy is a relatively common condition in childhood with a generally favorable prognosis of the affected population. Nevertheless, a significant minority of the treated children do not respond to the medical treatment so that surgical treatment is necessary. While minor surgical procedures have a negligible incidence of mortality, major ones may carry a significant risk of perioperative complications. The leading cause of mortality is represented by hemorrhagic derangements after high intraoperative and postoperative blood loss, mostly in very young patients. Therefore, restoration of euvolemia, detection and correction of related bleeding disorders represent the major concern for pediatric neuroanesthesiologists and intensivists throughout the perioperative period. The present report is focused on the anesthesia and intensive care management of the surgical epileptic patient.
  
  
  CONCLUSIONS
  Authors recommend that these high-risk procedures should be performed in highly experienced centers where pediatric neurosurgery is performed daily.
authors.affiliation: Department of Anesthesiology and Intensive Care, Catholic University Medical School, Largo A. Gemelli, 1, 00168, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pietrini
authors.forename: F
authors.initials: F
authors.lastname: Zanghi
authors.forename: A
authors.initials: A
authors.lastname: Pusateri
authors.forename: F
authors.initials: F
authors.lastname: Tosi
authors.forename: S
authors.initials: S
authors.lastname: Pulitanò
authors.forename: M
authors.initials: M
authors.lastname: Piastra
mesh_terms: D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D004827:Epilepsy / Q000601:surgery*; D006801:Humans; D007223:Infant; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures / Q000379:methods*; D019990:Perioperative Care