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Pediatric Neurosurgery

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A special branch of neurosurgery which deals with brain and spine disorders of young children. It is a complete different approach to a young individual suffering from congenital or acquired disease. Common neurosurgical problems encountered in a child are –

  • Hydrocephalus – accumulation of cerebrospinal fluid (CSF) in the head. This may cause enlargement of head, intellectual deficits and difficulty in vision. The water may accumulate either due to congenital defects in the head or spine or it may follow episodes of meningitis. Treated early, the ill effects are avoided. Treatment involves bypassing the CSF to abdomen by a silicone tube placed internally (VP shunt). The most modern treatment is to use an endoscope to bypass the fluid inside the brain.
  • Myelomeningocele – absence of a portion of the backbone leading to herniation of a portion of the spinal cord to the outside. This may produce weakness and paralysis of lower limbs along with difficulty in passing urine and stool. Ideally should be treated within first 24 hours of birth. Can be complicated with hydrocephalus, neck problems, various orthopedic deformities to be corrected at a later date.
  • Cranio-vertebral anomalies – includes various malformations of bone and ligaments at the junction of head and neck, also requiring surgical correction.
  • Spinal deformities – like scoliosis requiring correction with growing age
  • Pediatric brain tumours – require surgical treatment depending on the grade and extent of the tumor.
  • Epilepsy surgery – brain malformations causing epilepsy, not responding to medical treatment can be minimized with surgery

Case Study

  • Child Neurosurgery A 3-day old newborn was brought to Dr. Sil with a large swelling at the back of the head mimicking a second head. Internally the brain and its contents had herniated out into a large cyst ( Occipital encephalocele). Operating this tiny neonate was an uphill surgical and logistic challenge. After a 6 hour long surgery, the baby was operated on successfully and the skull repaired to normal. The child has recovered well and is now 2 years old.