[Anesthesia-resuscitation for intracranial expansive processes in children]

Area of Science:

• Neurology
• Pediatric Neurosurgery
• Anesthesiology

Context:

• Space-occupying cerebral lesions are common in children, including brain tumors and arteriovenous malformations.
• These lesions cause increased intracranial pressure (ICP), hydrocephalus, and specific neurological deficits based on location.
• Understanding lesion characteristics is vital for planning anesthetic and surgical interventions.

Purpose:

• To outline the critical factors in managing pediatric patients with space-occupying cerebral lesions.
• To highlight the importance of anesthetic protocols and surgical techniques tailored to lesion type and location.
• To emphasize the risks associated with specific lesion types and surgical positions.

Summary:

• Pediatric brain tumors and arteriovenous malformations are frequent causes of intracranial hypertension, hydrocephalus, and neurological deficits.
• Posterior fossa tumors risk obstructive hydrocephalus and brainstem compression; pituitary/chiasmatic tumors risk visual and endocrine disturbances; cortical tumors risk seizures and motor deficits.
• Anesthetic management requires careful consideration of lesion specifics, aiming for stable hemodynamics and preventing complications like venous air embolism.

Impact:

• Informed anesthetic and surgical planning improves patient safety and outcomes for pediatric neurosurgical cases.
• Effective management of intracranial hypertension and associated deficits is critical for preventing long-term neurological sequelae.
• Close postoperative surveillance and individualized extubation strategies are essential for minimizing complications.