Management Of Childhood Brain Tumors (foundations Of Neurological Surgery)

Developments in the field of instrumentation of innovative instrumentation. Although laser applications have permeated nearly every aspect are among the major contributions to human advancement. The history of surgery has seen of surgical therapy, the expectations have fre­ many revolutionary developments cause quantum quently been unrealistic and the evaluation of leaps in progress. Electrocautery, the anesthesia technological development has always been machine, computed axial tomography, and the painfully slow. The properties of vaporization, surgical microscope are all revolutionary in­ coagulation, and cutting unified in an invisible struments that have irrevocably changed the shaft of light have enabled the neurosurgeon to direction of neurological surgery. vaporize inaccessible tumors of brain and spinal In the early stages of application, there are cord, harness recalcitrant bleeding sites, and cut always detractors and valid controversy concern­ through the most formidable calcified tumors. ing the value of a new instrument. Some will The application of this new energy form in remember those who argued that the magnifica­ tandem with the surgical microscope has, in my tion and illumination provided by the micro­ opinion, extended the scope of all aspects of scope were not valuable to the skilled surgeon neurosurgery. We have much more work to do. and would prolong the operative time and in­ lt is necessary to document improved results and crease infection rates. Others may recall that demand technological advances and safe inno­ Cushing was told to abandon the blood pressure vations. In Children, The Central Nervous System Tumors Complished Through Advances In The Three Main Are Exceeded In Incidence Only By Leukemia And Antineoplastic Therapeutic Modalities-surgery, Are More Common Than Any Of The Other Malig Radiation Therapy, And Chemotherapy. Improve Nancies Of Childhood. Childhood Central Nervous Ments In Neurosurgical Technique Concomitant System Tumors Encompass A Range Of Histo With Improvements In Anesthesia And Periopera Logic Varieties From The Histologically Benign Tive Supportive Care Have Resulted In Decreased Appearing Pilocytic Astrocytoma To The Extremely Morbidity And Mortality From Neurosurgical Malignant-appearing Glioblastoma Multiforme Procedures Together With An Increased Likelihood Of Accomplishing A Gross Total Resection Of And The Undifferentiated Primitive Neuroecto Dermal Tumors. Similarly, The Biologic Behavior Tumor. Radiotherapy Has Evolved From Using Orthovoltage (200-250 Kv) Equipment To Of Childhood Brain Tumors Varies Not Only Ac Cording To Histology But Also With Location Of Supervoltage Equipment With Much-improved The Tumor And Age. Unlike Primary Central Nerv Penetration, Thus Allowing For The Administra Ous System Tumors In Adults, Many Varieties Of Tion Of Accurate Homogeneous High Doses To Childhood Brain Tumors Have The Propensity To Large Volumes Without Significant Effects On The Disseminate Via The Cerebrospinal Fluid Path Overlying Skin And Soft Tissues. Preliminary Data Ways. Front Matter....Pages i-xii Introduction....Pages 1-3 Tumors of the Central Nervous System in Children....Pages 5-51 Diagnostic Radiology of Childhood Brain Tumors....Pages 53-119 Neurological Assessment....Pages 121-135 Endocrine and Systemic Manifestation of Brain Tumors in Children....Pages 137-173 Surgery....Pages 175-185 Radiotherapy....Pages 187-231 Pathophysiologic Basis for Brain Tumor Chemotherapy....Pages 233-271 Visual Pathway Gliomas....Pages 273-284 Craniopharyngiomas....Pages 285-307 Pituitary Adenomas in Childhood....Pages 309-323 Cerebral Hemisphere Glioma....Pages 325-342 Supratentorial Primitive Neuroectodermal Tumors....Pages 343-355 Meningioma....Pages 357-368 Ependymomas....Pages 369-382 Intracranial Germ-Cell Tumors....Pages 383-399 Midline Intra—Axial Tumors (Nuclear and Brainstem)....Pages 401-409 Medulloblastoma....Pages 411-440 Cerebellar Astrocytomas....Pages 441-456 Brain Metastases....Pages 457-464 Recurrent Central Nervous System Tumors....Pages 465-479 Late Sequelae in Survivors of Childhood Brain Tumors....Pages 481-491 Long-term Neuropsychologic and Intellectual Sequelae in Brain Tumor Patients....Pages 493-500 Second Primary Tumors in Treated Patients....Pages 501-510 Erratum to: Tumors of the Central Nervous System in Children....Pages 511-515 Back Matter....Pages 517-523 Edited By Jon H. Robertson, W. Craig Clark. Includes Bibliographical References And Index.