Stereotactic neurosurgery in children and adolescents

Between March 1992 and January 1998, 100 stereotactic procedures were carri ed out in Our Stereotactic Department. Of these, 24 were performed on patie nts under 18 years of age, 22 of them under a local anaesthetic and sedatio n. The ages of these patients ranged between 4 months and is years. The ste reotactic procedures carried out were: 15 cerebral biopsies, 5 iodine-125 i mplants, 4 implantations of Rickham reservoirs with ventricular catheter, w ith additional holes to establish a connection between the cyst content and the ventricular system (internal drainage): 2 of these patients had arachn oidal cysts in the pineal region, 1 a thalamic neuroepithelial cyst and 1 a cystic craniopharyngioma, with excellent control of hydrocephalus. All cer ebral biopsies were positive, including 3 in which brain stem tumours were detected. Of the 5 patients treated by brachytherapy, 4 had pilocytic astro cytomas and. 1 an anaplastic astrocytoma. The sites of the tumours for whic h implants were used were the thalamus in 4 cases, and the basal ganglia (c orpus striatum) in 1. In only 2 cases was there some transistory morbidity, and mortality was nil. The stereotactic procedures in this varied group we re well tolerated, with low morbidity and mortality rates, which proves tha t this method is effective and safe for patients. It can also be used for t he diagnosis of brain stem tumours. Midline cysts can also be treated by me ans of internal drainage with catheters (a minimally invasive form of surge ry).