Surgery of pineal region lesions in childhood.

Personal experience with surgical exploration and total resection or evacuation of pineal and midbrain mass lesions in 20 pediatric patients from a total material of 52 cases demonstrate the efficacy of modern microsurgical techniques. Microtopography indicated the choice of the most suitable approach to these deep-seated lesions. The infratentorial supracerebellar approach proved to be the ideal exposure, except in one case of a lesion in the interpeduncular cistern, where a subtemporal approach was chosen. There was only one death as a consequence of the operation in a case of an extensive medulloblastoma; in all the other cases, no increase in morbidity occurred after surgery. Duration of post-operative observation with individual survival times will be demonstrated.