Method to perform safety stereotactic procedures in children under 2 years of age

Childs Nerv Syst. 2018 Mar;34(3):555-558. doi: 10.1007/s00381-017-3624-6. Epub 2017 Oct 23.

Abstract

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 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.

Keywords: Brain biopsy; Frame fixation; Pediatric stereotactic; Safety; Thin skull bone.

MeSH terms

  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / surgery*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Infant
  • Male
  • Neurosurgical Procedures / instrumentation*
  • Neurosurgical Procedures / methods*
  • Stereotaxic Techniques / instrumentation*
  • Tomography, X-Ray Computed / methods