title: Intra-operative neurophysiological mapping and monitoring during brain tumour surgery in children: an update.
abstract: BACKGROUND
  Over the past decade, the reluctance to operate in eloquent brain areas has been reconsidered in the light of the advent of new peri-operative functional neuroimaging techniques and new evidence from neuro-oncology. To maximise tumour resection while minimising morbidity should be the goal of brain surgery in children as much as it is in adults, and preservation of brain functions is critical in the light of the increased survival and the expectations in terms of quality of life.
  
  
  CONCLUSIONS
  Intra-operative neurophysiology is the gold standard to localise and preserve brain functions during surgery and is increasingly used in paediatric neurosurgery. Yet, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation, and some technical aspects need to be tailored for its use in children, especially in infants. This paper will review the most recent advances in the field of intra-operative neurophysiology (ION) techniques during brain surgery, focussing on those aspects that are relevant to the paediatric neurosurgery practice.
authors.affiliation: Pediatric Neurosurgery, Institute of Neurosurgery, University Hospital, Verona, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Coppola
authors.affiliation: Division of Neurology, University Hospital, Verona, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tramontano
authors.affiliation: Division of Neurology, University Hospital, Verona, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Basaldella
authors.affiliation: Division of Neurology, University Hospital, Verona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Arcaro
authors.affiliation: Division of Neurology, University Hospital, Verona, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Squintani
authors.affiliation: Pediatric Neurosurgery, Institute of Neurosurgery, University Hospital, Verona, Italy. francesco.sala@univr.it.|Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. francesco.sala@univr.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sala
mesh_terms: D001931:Brain Mapping; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy; D004569:Electroencephalography; D004576:Electromyography; D005071:Evoked Potentials / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D016343:Monitoring, Intraoperative; D009044:Motor Cortex / Q000503:physiopathology; D019635:Neurosurgical Procedures / Q000379:methods*; D010775:Photic Stimulation
keywords: Children; Cortical mapping; Intraoperative neurophysiology; Motor evoked potentials; Neuromonitoring; Paediatric brain tumours; Subcortical mapping