Method perform safety stereotactic procedures in children under 2 years of age.
Article published in Childs Nerv Syst 2018;34:555-8. Translation: Dr. Tania Acosta
DOI:
https://doi.org/10.47924/neurotarget201894Keywords:
Pediatric stereotactic, Frame fixation, Brain biopsy, Safety, Thin skull boneAbstract
Introduction: Stereotactic procedures have been used in neurosurgery for many years. In children especially, care should be considered to avoid complication caused by fixation of the frame in a not fully developed skull bone. We present our method to adapt the frame in children under 2 years of age.
Methods: Twelve procedures in patients under 24 months were performed between 2003 and 2015. Micromar (MR) frame was used. It was adapted with a small pillow made of gauss attached to the posterior part to hold the head, then four pins were fixed without adjustment. We analyze for each patient age, indication, histopathology, and complications.
Results: Eleven patients with a mean age of 13.5 months (range 9 to 22 months) underwent 12 stereotactic procedures. In all cases, biopsy samples were obtained, histopathology was positive in 11/12 cases. No complications occurred.
Conclusion: Stereotactic frame procedures need special attention in small children where the skull bones are not fully developed. We present a simple method to perform this surgery in patients under 2 years of age.
Metrics
References
Aoki N, Sakai T (1989) Modified application of three-point skull clamp for infants. Neurosurgery 25:660-2
Berry C, Sandberg D, Hoh D et al (2008) Use of cranial fixation pins in pediatric neurosurgery. Neurosurgery 62(4):913-7
Furlanetti L, Monaco B, Cordeiro J, Contreras Lopez W, Trippel M (2015) Frame-based stereotactic neurosurgery in children under the age of seven: Freiburg University’s experience from 99 consecutive cases. Clin Neurol Neurosurg 130:42-7
Haas LL (1952) Roentgenological skull measurements and their diagnostic applications. Am J Roentgenol Radium Ther Nucl Med 67:197-209
Knodziolka D, Adelson P (1996) Technique of stereotactic biopsy in a 5-month-old child. Childs Nerv Syst 12:615-8
LeeM, Rezai A, Chou J (1994)Depressed skull fractures in children secondary to skull clamp fixation devices. Pediatr Neurosurg 21: 174-8
LetsM, Kaylor D, GouwG (1988) Abiomechanical analysis of halo fixation in children. J Bone Joint Surg Br 70:277-9
Ostertag CB, Männer HD, Kiessling M (1980) Stereotactic biopsy of brain stem tumors. Surg Neurol 14:275-83
Pattisapu J, Walker M, Heilbrun P (1989) Stereotactic surgery in children. Pediatr Neurosci 15:62-5
Puget S, Beccaria K, Blauwblomme T, Roujeau T et al (2015) Biopsy in a series of 130 pediatric diffuse intrinsic Pontine gliomas. Childs Nerv Syst 31:1773-80
Sgouros S, Grainger MC, McCallin S (2005) Adaptation of skull clamp for use in image-guided surgery of children in the first 2 years of life. Childs Nerv Syst 21:148-9
Uematsu S, Rosenbaum A, Abel D et al (1987) Helmet for infant skull fixation during stereotactic neurosurgery. Appl Neurophysiol 50:114-8
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Ramiro J. del Río, Roberto O. González, Roberto Jaimovich
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
