Endoscopic head base surgery has grown to become a fundamental element of the current neurosurgical armamentarium. The pioneering efforts where the purely endoscopic transsphenoidal approach was introduced have actually caused an increasing wave of utilizing the endoscopic endonasal procedures for a sizable variety of head base lesions. Because of their anatomical peculiarities, lesions of the sellar and parasellar areas provide by themselves perfectly towards the endoscopic endonasal approaches. In addition to the common pathological organizations, many other less frequent pathologies are experienced within the sellar and parasellar area. In this section, we review the surgical manner of the endoscopic endonasal transsphenoidal approach and its extensions applied to a variety of unusual and uncommon pathological organizations involving the sella turcica and clivus. A synopsis of those pathological entities normally provided and exemplified.Pediatric optic pathway gliomas (OPG) are low-grade brain tumors described as sluggish progression and invalidating visual reduction. Common therapeutic techniques consist of surgery, radiotherapy, chemotherapy, and combinations among these modalities, but despite the various treatment techniques, no real treatment is present to stop or revert aesthetic impairment. Nowadays, a few reports regarding the literature program biliary biomarkers promising results regarding NGF eye drop instillation and enhancement of artistic outcome. Such results seem to be related with the NGF-linked prevention in caspase activation, which reduces retinal ganglion cell loss.Reducing retinal ganglion cell loss results medically in aesthetic area improvement along with visual electric potential and optical coherence tomography gain. Nevertheless, aesthetic acuity does not show considerable modifications.Visual impairment presents nowadays one of many significant issues in dealing with OPGs. Additional towards the interesting outcomes provided by NGF attention drop administration, additional studies tend to be warranted to better comprehend potential treatment methods. Supraorbital craniotomy via an eyebrow incision provides minimally invasive cosmetically positive access to both orbital and intracranial pathologies. We describe the sign, surgical strategy, and medical program using this medical strategy in a cohort of patients from just one pediatric neurosurgery device. In a retrospective analysis, we identified all medical cases between January 2013 and April 2022 who underwent the supraorbital craniotomy via an eyebrow cut. Craniotomy had been performed utilizing piezosurgery ultrasonic bone incision. An interdisciplinary group of an orbital physician and a neurosurgeon carried out the orbital surgeries. Medical and medical characteristics, perioperative data, possible complications, or redo surgeries in addition to ophthalmologic standing were examined. Clinical data of 37 interventions (instances) in 30 customers (age 8±6.5years) had been reviewed. The supraorbital craniotomy established access into the cranial, lateral, and main portions for the orbit (n=11) and ipsilateral . Interdisciplinary cooperation enables a wider spectrum of medical choices in orbital and complex, fronto-basal, skull base pathologies.The supraorbital eyebrow approach is possible and safe in pediatric neurosurgical cases as a minimally invasive and cosmetic positive Acute care medicine method and really should be considered for intraorbital along with ipsilateral intracranial lesions right beside the head base. Interdisciplinary collaboration enables a broader spectral range of surgical choices in orbital and complex, fronto-basal, skull base pathologies.Chiari type 1 malformation (CIM) is defined as tonsillar ectopia of >5 mm, while syringomyelia (SM) is described as a cerebrospinal fluid (CSF)-filled hole larger than 3 mm dissecting the spinal-cord. During the last years, our knowledge of these pathologies has exploded; however, many controversies still exist very nearly in almost every part of CIM and SM, including etiology, sign for therapy, time of treatment, surgical method, follow-up regime, and result. This chapter provides an extensive overview on different factors of CIM and SM as well as on the however current controversies, on the basis of the proof presently readily available. Future directions for clinical study regarding CIM and SM treatment and result are elaborated and talked about as well.The biggest challenge for physicians and surgeons in terms of radiological examinations could be the ability to request the best modalities and to understand the skills and limitations of every modality. This really is particularly essential in paediatric neurosciences where despite magnetized resonance imaging (MRI) being the primary imaging modality, there are lots of protocols, technical limits of specific scanners and dilemmas related to sedation that have to be considered. In this section, we explain a straightforward strategy for six typical neurosurgical conditions to guide the paediatric neurosurgeons in asking for the right MR protocol and knowing the rationale of it.Paediatric neuro-oncology, epilepsy and neck/skull base protocols tend to be discussed elsewhere in this book and as a consequence won’t be selleck products a focus in this part (Bernasconi et al., Epilepsia 601054-68, 2019; D’Arco et al., Neuroradiology 641081-100; 2022; Avula et al., Childs Nerv Syst 372497-508; 2021).Intraoperative neurophysiology (ION) in brainstem surgery developed as brainstem surgery advanced.The original notion of brainstem mapping (BSM) is a neurophysiological procedure to find cranial nerve motor nuclei (CNMN) on the floor associated with the fourth ventricle. With the introduction of numerous skull base approaches towards the brainstem, BSM is carried out on any surface regarding the brainstem to reveal the safe entry area towards the intrinsic brainstem lesion. It will be the modern concept of BSM, a broader concept of BSM. BSM allows in order to prevent direct harm to the CNMN when nearing the brainstem through the unfavorable mapping region.The corticobulbar tract (CBT) motor evoked potential (MEP) is another ION procedure in brainstem surgery. It enables tabs on the practical stability regarding the whole cranial engine pathway without interrupting surgical treatments.