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School of Medicine
Treating Brain Tumors in Children: Advances in Neurosurgery
While a daunting consideration for parents, neurosurgery can be an effective and successful treatment for pediatric brain tumors. Advances in imaging guidance and surgical techniques have revolutionized pediatric neurosurgery over the past few decades.
Today, a successful result is possible for the majority of children diagnosed with a brain tumor. Alan Cohen, M.D., director of pediatric neurosurgery at Johns Hopkins Children’s Center, discusses the advances in pediatric brain tumor treatment and explains what you should know about each one.
Using Surgery to Treat Brain Tumors in Children
Surgery to remove a tumor (part or whole) can effectively treat or control many pediatric brain tumors. For low-grade, or low-risk, tumors, surgery alone may be sufficient. Other times, a pediatric neurosurgeon may recommend surgery in combination with:
Doctors will often recommend surgery when a tumor:
- Presents a danger to a child’s long-term health or development.
- Is positioned in such a way that doctors are able to safely and effectively reach it.
Advanced Technologies in Pediatric Brain Tumor Treatment
Today, pediatric neurosurgeons use the latest technology to successfully treat children with brain tumors:
- An operative microscope: This specialized microscope magnifies everything doctors are looking at during surgery so they can make precise incisions. When doctors can see intricate details of the surrounding tissue, they can make better decisions that lead to more effective results.
- Endoscopes: These are miniaturized instruments that doctors use to see inside the body with a small access point. Endoscopy helps doctors perform intricate surgeries with only a tiny incision instead of removing a larger piece of the skull to access the brain. Endoscopes help doctors operate safely and can result in:
o Minimal disruption of the brain
o Fewer complications
o A shorter hospital stay
o A quicker recovery
Minimally Invasive Approaches to Pediatric Brain Tumor Surgery
When an endoscopic approach isn’t suitable due to a tumor’s size or location, our neurosurgeons have refined their techniques to offer other minimally invasive approaches. This includes:
- Neuroendoscopy: For this hybrid approach combining endoscopy and open microsurgery, surgeons use instruments that are slightly larger than an endoscope.
- Endoscopic endonasal surgery: Surgeons operate through the nose using an endoscope and take out the tumor without making an opening in the skull.
- Endoscope-assisted microsurgery: Surgeons use an endoscope to assist a microscope, which can help surgeons see around corners or access hard-to-reach areas.
Targeted Approach Helps Treat Brain Tumors in Children
New technologies and capabilities help guide doctors to the right treatment for your child. Some can guide a surgeon’s movements during an operation, while others direct a doctor to more targeted medications for a particular tumor. This includes:
- Brain mapping: Doctors sometimes use a specialized type of MRI (functional or fMRI) to map out — and then avoid — intricate areas of the brain that control movement, for example, when performing surgery to remove a tumor. This makes neurosurgery safer.
- Ultrasound: Surgeons might use ultrasound technology during surgery to help guide their movements and ensure they don’t leave any remnants of tumor behind.
- Tumor profiling: Using molecular profiling, research has mapped out different subtypes of certain brain tumors. Doctors can analyze the brain tumor to determine if an effective medication is available for that particular tumor. If a tumor’s location makes surgery too dangerous, these new medications that target specific genetic mutations can effectively treat certain brain tumors.
In addition to surgical advances, innovations in imaging technology help doctors diagnose pediatric brain tumors earlier and guide treatment.