THE FUTURE PERSPECTIVES OF PEDIATRIC NEUROSURGERY

Pediatric neurosurgery as a subspecialty dealing primarily with such c ongenital and perinatal pathology as the dysraphic state, and various clinical entities having in common ventriculomegaly, is fast disappear ing from the scene of neurosurgery in the industrialized world. Pari p assu with this, one observes ever closer collaborative work between pe diatric neurosurgeons and specialists in other pediatric disciplines s uch as oncology, radiology, orthopedics, and maxillofacial surgery: tr uly multidisciplinary activities. In addition, paramedical and special ized nursing personnel are participating actively, even in the decisio nmaking and treatment-delivery aspects of pediatric neurosurgical care . The pediatric neurosurgeon is no longer the sole decision-maker, nor the automatic captain of the ship. Very probably, as in the whole his tory of human activities, new instrumentation will change somewhat wha t we do and with whom eve collaborate. However, for the immediate futu re the major changes most probably will be expressions of socioeconomi c readjustments, of ethical redefinitions, and of the to-and-fro movem ent into and out of pediatric neurosurgery by both neurosurgeons and a ncillary medical personnel.