Pediatric Neurosurgery

The area of the field that deals with infants and children is paediatric neurosurgery. As was already established, the paediatric neurosurgeon spends a significant amount of time treating hydrocephalus. Treatment of additional congenital malformations, neurotrauma, functional issues like spasticity and epilepsy, children's cerebrovascular illnesses, brain tumours, and congenital deformities of the spine and spinal cord are also addressed by paediatric neurosurgery.

A larger head circumference, full and tense fontanelles, and wider cranial sutures are signs of hydrocephalus in neonates. The child may exhibit poor eating and lethargy, as well as extraocular anomalies that impair upgaze. Using CT, MRI, or ultrasound, a diagnosis is made.

Infants and babies with hydrocephalus may be born with it or develop it later in life. Acquired hydrocephalus typically communicates, but congenital hydrocephalus is typically obstructive. Prematurity or post infection (meningitis, intrauterine toxoplasmosis infection, CMV infection) are the two most common causes of acquired hydrocephalus in neonates (intraventricular hemorrhage). Aqueductal stenosis, Chiari II malformation, Dandy-Walker malformation, vein of Galen aneurysms, tumours, and arachnoid cysts are a few congenital disorders that can result in hydrocephalus. Obstructive hydrocephalus is brought on by aqueductal stenosis, which prevents spinal fluid from flowing freely from the third ventricle to the fourth ventricle. Fourth ventricular outflow blockage is brought on by Chiari II malformation. The absence of the cerebellar vermis, cystic growth of the fourth ventricle, and hydrocephalus are all symptoms of the Dandy-Walker deformity. Through an obstructive mechanism, tumors, arachnoid cysts, and vein of Galen aneurysms cause hydrocephalus.

The prevention of neurologic damage, which could happen if hydrocephalus is left untreated, is the main goal of treatment. Neurologic deficits may occasionally be reversible. Treatment usually requires CSF diversion together with the removal of the offending lesion (tumor removal or infection treatment). The peritoneal cavity serves as the distal terminal for most shunts. The pleural cavity and superior vena cava are additional locations. Procedures for diverting CSF are not without risk, and 5% to 15% of all shunts end up contaminated. Shunt infections are often treated by externalising or removing the device, sterilising the spinal fluid, and ultimately replacing the shunt.

Patients with obstructive hydrocephalus and intact arachnoid granulations with the ability to reabsorb CSF frequently undergo endoscopic third ventriculostomy surgery. Even though the causes of endoscopic third ventriculostomy and its outcomes have been widely studied, the indications are still being improved.

In a neurosurgical surgery called a ventriculostomy, a drainage hole (or stoma) is made inside the cerebral ventricle. It is usually carried out on people who have hydrocephalus. In order to access the brain ventricle, the skull, dura mater, and brain are surgically penetrated. An External Ventricular Drain (EVD) is a typical term used to describe temporary catheter drainage. The term "shunt" is typically used when catheter drainage is ongoing. Many catheter-based ventricular shunts are named after the area in which they come to an end. For instance, a ventriculo-peritoneal shunt ends in the peritoneal cavity, a ventriculoatrial shunt ends in the heart's atrium, etc. Kocher's point, which is 3 cm laterally from the midline and 11 cm posteriorly from the nasion, is the most typical entry site on the skull.  External Ventricular Drain (EVD) ventriculostomy is performed primarily to relieve pressure on the Central Nervous System (CNS) by draining blood or Cerebrospinal Fluid (CSF), as well as monitoring intracranial pressure.

                                        Surgery Current Research

Surgery Current Research is a global open-access, peer-reviewed journal that emphasises medical specialties and concentrates on manual operation and cutting-edge instrumental procedures used in the current research sector. Surgical procedures and academic research on patients are used to treat pathological conditions including disease, burns, and injuries and then to use surgery to study how the body functions or looks. Access to the journal's content is free. In the vast range of surgical classifications, the journal covers both invasive and non-invasive surgical techniques. The submission can take the form of research, reviews, case reports, commentary, editorials, etc.

Journal Highlights

•          Neurosurgery

•          Cardiac Surgery

•          Transplant surgery

•          Liver Surgery

•          Thoracic Surgery

Email Id: surggenopen@peerjournal.org   

Submission Link: https://www.longdom.org/submissions/surgery-current-research.html