Pediatric neurosurgery, which by its nature overlaps multiple neurosurgical subspecialties, has benefited greatly from the advances in minimally invasive neurosurgical techniques. Not only can it take advantage of the progress in the areas of vascular, spine, trauma, and tumor neurosurgery, but as a subspecialty it has significantly advanced the minimally invasive treatment of hydro-cephalus and intraventricular lesions.

There have been substantial technological advances in the treatment of hydrocephalus in the past half century. Ventricular shunts, our current mainstay of treatment, can be considered a minimally invasive alternative to the techniques that preceded them for the treatment of hydrocephalus. However, neuroendoscopy is now the leading edge technology in the treatment of this condition and has become an important part of the armamentarium of all pedi-atric neurosurgeons. The current goal in hydrocephalus is to treat the patient without a shunt, or at least to simplify shunt systems as much as possible by fenestration of loculated fluid spaces. In this chapter we review how pediatric neurosurgeons employ minimally invasive techniques in their practice for the treatment of hydrocephalus, cysts, tumors, and vascular and congenital abnormalities of the brain and spine.

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