Pediatric neurosurgery in Tijuana

A child is not a small adult

A child's nervous system is growing, and that changes everything: how a problem announces itself, the window in which to act, and the follow-up needed afterwards. A skull with open sutures absorbs pressure in a way an adult skull cannot, which is why childhood hydrocephalus is picked up by measuring head circumference before any other symptom appears.

The practical consequence is that in paediatrics some conditions are watched longer and decided with more temporal margin, and others with far less delay. Craniosynostosis, for example, gives better results operated within the first months of life, while bone is still malleable.

The commonest conditions

Congenital and post-haemorrhagic hydrocephalus; myelomeningocele and other forms of spina bifida; craniosynostosis and cranial deformities; tethered cord syndrome; arachnoid cysts; childhood brain tumours, frequently in the posterior fossa; and paediatric head trauma.

Also assessed are positional plagiocephaly — which is not craniosynostosis and needs no surgery — dermal sinus, Chiari malformation and congenital malformations of the central nervous system. Telling what needs theatre from what needs surveillance is a large part of the job.

How the work with parents is done

A neurosurgical diagnosis in a child is among the hardest situations a family goes through. The consultation is organised around that: the diagnosis is explained in words that make sense, the images are shown, what is known and what is not yet known are both stated, and questions are answered until they run out.

Come as both parents if you can, bring your questions written down, and hold none of them back for seeming basic. The decision has to be yours, made with enough information — not a signature placed on a document nobody finished reading.

Follow-up matters as much as the surgery

In paediatrics, many of these conditions do not end with the operation. A child with a shunt for hydrocephalus grows, and the distal catheter that fitted at two can be short by eight. A myelomeningocele closed in the newborn needs surveillance for tethered cord, urological function and Chiari malformation for years.

So treatment is carried out with paediatrics, urology, orthopaedics and rehabilitation, and follow-up visits are not a formality: they are when problems get caught early that, caught late, cost far more.