SURG-15. THE SURGERY OF THALAMIC LESIONS IN PEDIATRIC BRAIN TUMORS

BACKGROUND: Pediatric brain tumors are occurred in the center of central nervous system. Since mid-line glioma has defined in the new classification, thalamus has attracted attention as a site that requires surgical intervention. However, the surgery for thalamus is a challenging procedure for neurosurgeons. In this study, we studied our surgical cases of patients suffering from pediatric brain tumors in thalamus and/or thalamic regions to evaluate the safety of surgeries and the consideration of appropriate surgical approaches. METHODS: We reviewed neuroradiological images, medical record, and, surgical videos for the assessment of surgical fields in patients under the age of 15 who had surgical treatments at our institution. RESULTS: We had six cases that could be analyzed. The lesions in the posterior parts of the thalamus had been operated by the occipital transtentorial approach. The lesions in the superior parts of thalamus were treated with transcortical transventricle approach. It was possible to achieve sufficient removal of tumors and have good surgical view. The monitoring of motor function and visual function was used in all cases. After removal, we could have a nice view of the important structures around thalamus. CONCLUSIONS: The surgeries for thalamus and thalamic regions were safety with enough considerations for neurological examinations and radiological imaging. The intra operative monitoring for motor and visual function should be used.