Clinical Pearls Treatment decision making for arteriovenous malformations should take into account the lifetime risk associated with the aggressive natural history of these lesions. Whenever surgically feasible (specifically for grades I through III lesions), microsurgical resection with multimodality therapy (endovascular…
Clinical Pearls The most common solid tumor in pediatrics is a central nervous system tumor, accounting for 20% to 25% of all childhood neoplasms. In childhood, 75% of congenital brain tumors are supratentorial. Initial presenting symptoms can include hydrocephalus, palpable…
Clinical Pearls Craniopharyngioma is a histologically benign tumor, which presents special challenges to the neurosurgeon due to a combination of its highly eloquent location and locally recurrent nature. Craniopharyngioma can present with visual, neurologic, or endocrine symptoms. Neurosurgeons managing craniopharyngioma…
Clinical Pearls Posterior Fossa Tumors Due to the location of posterior fossa tumors, they share common presenting features related to the development of hydrocephalus. They are histologically diverse, with different underlying genetic mutations and prognoses. Magnetic resonance imaging (MRI) of…
Clinical Pearls Chiari malformations are pathologic herniations of the hindbrain through the foramen magnum and into the cervical spinal canal. Chiari malformations are being recognized with increasing frequency because of the increased availability of magnetic resonance imaging (MRI). Chiari I…
Clinical Pearls In craniosynostosis, skull growth is arrested in the direction perpendicular to the fused suture and expanded at the sites of unaffected sutures (Virchow's law), leading to characteristic calvarial deformations. In addition, the skull base and calvarial development are…
Clinical Pearls Hydrocephalus is one the most common conditions treated by neurologic surgeons, particularly among the pediatric population. It can also be one of the most challenging. Obstruction of cerebrospinal fluid (CSF) pathways or impaired CSF resorption causes hydrocephalus, which…
Clinical Pearls Spinal dysraphism is a spectrum of disorders resulting from incomplete formation of the neural tube or abnormal development of structures immediately associated with the neural tube and nearby somites. Several forms of dysraphism, including myelomeningocele, have been linked…
Clinical Pearls Surgical positioning aims to optimize access to surgical pathologies, avoid secondary injuries, and decrease operator fatigue. Commonly used patient positions for cranial and spine cases are discussed. Neuronavigation helps to improve surgical accuracy and decrease injury to critical…
Clinical Pearls A systematic preanesthesia evaluation including optimization of coexisting diseases is critical for optimal perioperative care, preventing last-minute cancellations and reducing the risk of adverse outcomes. The perioperative surgical home is a team-based model of care, the goals of…