There are three surgical procedures that may be performed on children with certain brain tumors. All of these are best performed by highly skilled pediatric neurosurgeons with experience in children’s brain tumors. A child diagnosed with a brain tumor should be seen by a pediatric neurosurgeon who specializes in brain tumors in children and young adults. (See Doctors Who Treat Pediatric Brain Tumors.)
Surgical biopsy: The first surgery a patient may have is a biopsy, to extract a sample of the tissue to determine what it is. Many types of brain tumors cannot be biopsied effectively because they are so diffuse. Some tumors are in difficult-to-reach locations in the brain and are not biopsied in advance of resection surgery – samples are sent to a pathology lab during the surgery to remove the tumor.
Resection (removal): A highly skilled pediatric neurosurgeon will perform a craniotomy or craniectomy to remove a portion of the skull to gain access to the tumor to remove it. The goal of the surgery is to remove as much of the tumor as possible without damaging healthy brain tissue. In other areas of the body, surgeons remove not just the tumor but a small margin of healthy tissue around it to capture any stray cancer cells. That’s not possible in the brain, where removing healthy tissue can cause neurological deficits (motion, speech, or other functions). The skill and training of the neurosurgeon is critical to how much of the tumor can be removed.
Shunt placement/revision: A tumor may be blocking the normal flow of cerebrospinal fluid (CSF), leading to a buildup of pressure in the brain (hydrocephalus). A neurosurgeon can place a temporary drain, called a ventriculostomy or external ventricular drain (EVD), to relieve pressure. An internal shunt is a more permanent solution – it drains CSF into the patient’s abdomen, where it is absorbed into the body. Shunts may sometimes need to be repositioned to continue to drain effectively, a procedure known as a shunt revision.
At Weill Cornell Brain and Spine Center, our pediatric neurosurgeons are highly skilled in the most advanced procedures for treating brain tumors in children. Our relationships with top hospitals, including NewYork/Presbyterian and Memorial Sloan-Kettering, allow our surgeons access to the very best facilities and specialists, as well as the most leading-edge research laboratories, to ensure that your child gets the very best treatment available. You can request an appointment using our online form.
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Reviewed by Jeffrey Greenfield, M.D./Ph.D.
Last reviewed/last updated: August 2021
