title: Recent technological advances in pediatric brain tumor surgery.
abstract: X-rays and ventriculograms were the first imaging modalities used to localize intracranial lesions including brain tumors as far back as the 1880s. Subsequent advances in preoperative radiological localization included computed tomography (CT; 1971) and MRI (1977). Since then, other imaging modalities have been developed for clinical application although none as pivotal as CT and MRI. Intraoperative technological advances include the microscope, which has allowed precise surgery under magnification and improved lighting, and the endoscope, which has improved the treatment of hydrocephalus and allowed biopsy and complete resection of intraventricular, pituitary and pineal region tumors through a minimally invasive approach. Neuronavigation, intraoperative MRI, CT and ultrasound have increased the ability of the neurosurgeon to perform safe and maximal tumor resection. This may be facilitated by the use of fluorescing agents, which help define the tumor margin, and intraoperative neurophysiological monitoring, which helps identify and protect eloquent brain.
authors.affiliation: Department of Pediatric Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.|Department of Pediatric & Adult Neurosurgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.
authors.forename: Bassel
authors.initials: B
authors.lastname: Zebian
authors.affiliation: Department of Pediatric & Adult Neurosurgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vergani
authors.affiliation: Department of Pediatric & Adult Neurosurgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.
authors.forename: José Pedro
authors.initials: JP
authors.lastname: Lavrador
authors.affiliation: Department of Neurosurgery, Leeds General Infirmary, Leeds LS1 3EX, UK.
authors.forename: Soumya
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Department of Pediatric Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: William John
authors.initials: WJ
authors.lastname: Kitchen
authors.affiliation: Department of Pediatric Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Vita
authors.initials: V
authors.lastname: Stagno
authors.affiliation: Department of Pediatric Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Christos
authors.initials: C
authors.lastname: Chamilos
authors.affiliation: Department of Pediatric Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Pettorini
authors.affiliation: Department of Pediatric Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Conor
authors.initials: C
authors.lastname: Mallucci
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000266:history / Q000295:instrumentation* / Q000639:trends; D038361:Neuronavigation / Q000266:history / Q000639:trends; D010372:Pediatrics / Q000639:trends
keywords: Brain tumor; endoscope; microscope; paediatric; technological advances