[The specificity of neurosurgical anesthesia for the child]

Anaesthesia for paediatric neurosurgical procedures presents an interesting challenge to the anaesthesiologist. The child is not simply a small adult. At birth the central nervous system (CNS) development is incomplete and will not be mature until the end of the first year of life. Because of this delay in the maturation of the CNS, several specific pathophysiological and psychological differences ensue. Although one has little control on the child primary lesion, the selection of an anaesthetic technique designed to protect the perilesional area and the recognition of perioperative events and changes may well have a profound effect in the reduction or prevention of significant morbidity. Current neuroanaesthestic practice is based on the understanding of cerebral anatomy and physiology. Paediatric neuroanaesthesiologists must face the added challenge of the physiological differences between developing children and their adult counterparts.