{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:36:14Z","timestamp":1781584574565,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Intraoperative neurophysiological monitoring (IONM) has become an essential tool in neurosurgery, yet its application in pediatric cerebrovascular pathology remains scarcely documented. This paper aims to evaluate current evidence regarding the use of IONM in pediatric vascular neurosurgery and to present an institutional experience with AVM and cavernoma surgery performed with intraoperative neuromonitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review of literature was conducted and a 13-year retrospective pediatric institutional case series was reported, including 8 AVMs and 4 cavernomas operated with IONM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only five studies met the inclusion criteria, mostly consisting of case reports or small series, confirming the paucity of literature in this field. Reported experiences consistently described IONM as useful for detecting ischemia, guiding subcortical dissection, identifying safe brainstem or cortical entry zones, and supporting functional preservation. In the institutional series, IONM enhanced surgical resection safety by guiding temporary clipping in AVMs, facilitating identification of eloquent pathways during nidus dissection, and assisting in cortico-subcortical mapping in cavernoma surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite limited published evidence, our institutional experience supports the value of IONM as a technically feasible and potentially useful adjunct in pediatric vascular neurosurgery. For these malformations characterized by a high degree of surgical complexity, intraoperative neuromonitoring may further expand the armamentarium available to surgeons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07228-6","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T01:12:17Z","timestamp":1774401137000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraoperative neurophysiological monitoring in pediatric vascular neurosurgery: a review of the literature and institutional case series"],"prefix":"10.1007","volume":"42","author":[{"given":"Marco","family":"Galeazzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Montereale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Di Domenico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Frassanito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Massimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpiero","family":"Tamburrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"7228_CR1","doi-asserted-by":"publisher","DOI":"10.70389\/PJS.100080","author":"RA Agha","year":"2025","unstructured":"Agha RA, Mathew G, Rashid R, Kerwan A, Al-Jabir A, Sohrabi C, Franchi T, Nicola M, Agha M (2025) Revised preferred reporting of case series in surgery (PROCESS) guideline: an update for the age of artificial intelligence. PJS. https:\/\/doi.org\/10.70389\/PJS.100080","journal-title":"PJS"},{"key":"7228_CR2","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1007\/s00381-014-2442-3","volume":"30","author":"B Bilginer","year":"2014","unstructured":"Bilginer B, Narin F, Hanalioglu S, Oguz KK, Soylemezoglu F, Akalan N (2014) Cavernous malformations of the central nervous system (CNS) in children: clinico-radiological features and management outcomes of 36 cases. Childs Nerv Syst 30:1355\u20131366. https:\/\/doi.org\/10.1007\/s00381-014-2442-3","journal-title":"Childs Nerv Syst"},{"key":"7228_CR3","doi-asserted-by":"publisher","first-page":"357","DOI":"10.3171\/2020.7.PEDS20447","volume":"27","author":"G Boulouis","year":"2021","unstructured":"Boulouis G, Stricker S, Benichi S, Hak J-F, Gariel F, Alias Q, de Saint Denis T, Kossorotoff M, Bajolle F, Garzelli L, Beccaria K, Paternoster G, Bourgeois M, Garcelon N, Harroche A, Mancusi RL, Boddaert N, Puget S, Brunelle F, Blauwblomme T, Naggara O (2021) Etiology of intracerebral hemorrhage in children: cohort study, systematic review, and meta-analysis. J Neurosurg Pediatr 27:357\u2013363. https:\/\/doi.org\/10.3171\/2020.7.PEDS20447","journal-title":"J Neurosurg Pediatr"},{"key":"7228_CR4","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1007\/s00381-016-3180-5","volume":"32","author":"A Coppola","year":"2016","unstructured":"Coppola A, Tramontano V, Basaldella F, Arcaro C, Squintani G, Sala F (2016) Intra-operative neurophysiological mapping and monitoring during brain tumour surgery in children: an update. Childs Nerv Syst 32:1849\u20131859. https:\/\/doi.org\/10.1007\/s00381-016-3180-5","journal-title":"Childs Nerv Syst"},{"key":"7228_CR5","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/0090-3019(87)90284-9","volume":"27","author":"R Garza-Mercado","year":"1987","unstructured":"Garza-Mercado R, Cavazos E, Tamez-Montes D (1987) Cerebral arteriovenous malformations in children and adolescents. Surg Neurol 27:131\u2013140. https:\/\/doi.org\/10.1016\/0090-3019(87)90284-9","journal-title":"Surg Neurol"},{"key":"7228_CR6","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3171\/2015.2.PEDS14541","volume":"17","author":"BA Gross","year":"2016","unstructured":"Gross BA, Du R, Orbach DB, Scott RM, Smith ER (2016) The natural history of cerebral cavernous malformations in children. J Neurosurg Pediatr 17:123\u2013128. https:\/\/doi.org\/10.3171\/2015.2.PEDS14541","journal-title":"J Neurosurg Pediatr"},{"key":"7228_CR7","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1136\/neurintsurg-2021-017777","volume":"14","author":"J-F Hak","year":"2022","unstructured":"Hak J-F, Boulouis G, Kerleroux B, Benichi S, Stricker S, Gariel F, Garzelli L, Meyer P, Kossorotoff M, Boddaert N, Vidal V, Girard N, Dangouloff-Ros V, Brunelle F, Fullerton H, Hetts SW, Blauwblomme T, Naggara O (2022) Pediatric brain arteriovenous malformation recurrence: a cohort study, systematic review and meta-analysis. J Neurointerv Surg 14:611\u2013617. https:\/\/doi.org\/10.1136\/neurintsurg-2021-017777","journal-title":"J Neurointerv Surg"},{"key":"7228_CR8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1159\/000202622","volume":"45","author":"R Kumar","year":"2009","unstructured":"Kumar R, Shukla D, Mahapatra AK (2009) Spontaneous intracranial hemorrhage in children. Pediatr Neurosurg 45:37\u201345. https:\/\/doi.org\/10.1159\/000202622","journal-title":"Pediatr Neurosurg"},{"key":"7228_CR9","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/WNP.0b013e3181a03381","volume":"26","author":"JR L\u00f3pez","year":"2009","unstructured":"L\u00f3pez JR (2009) Neurophysiologic intraoperative monitoring of pediatric cerebrovascular surgery. J Clin Neurophysiol 26:85\u201394. https:\/\/doi.org\/10.1097\/WNP.0b013e3181a03381","journal-title":"J Clin Neurophysiol"},{"key":"7228_CR10","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/s0387-7604(03)00029-9","volume":"25","author":"AD Meyer-Heim","year":"2003","unstructured":"Meyer-Heim AD, Boltshauser E (2003) Spontaneous intracranial haemorrhage in children: aetiology, presentation and outcome. Brain Dev 25:416\u2013421. https:\/\/doi.org\/10.1016\/s0387-7604(03)00029-9","journal-title":"Brain Dev"},{"key":"7228_CR11","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_308_2023","volume":"14","author":"DTK Ndandja","year":"2023","unstructured":"Ndandja DTK, Musa G, Nosov I, Chmutin GE, Livshitz MI, Annanepesov NS, Mwela BM (2023) A rare case of rebleeding brainstem cavernoma in a 5-month-old-girl. Surg Neurol Int 14:227. https:\/\/doi.org\/10.25259\/SNI_308_2023","journal-title":"Surg Neurol Int"},{"key":"7228_CR12","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1093\/neuros\/nyy008","volume":"84","author":"E Oulasvirta","year":"2019","unstructured":"Oulasvirta E, Koroknay-P\u00e1l P, Hafez A, Elseoud AA, Lehto H, Laakso A (2019) Characteristics and long-term outcome of 127 children with cerebral arteriovenous malformations. Neurosurgery 84:151\u2013159. https:\/\/doi.org\/10.1093\/neuros\/nyy008","journal-title":"Neurosurgery"},{"key":"7228_CR13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hr\u00f3bjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"7228_CR14","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000001214","author":"M Palermo","year":"2025","unstructured":"Palermo M, Trevisi G, Albanese A, Sturiale CL (2025) The role of intraoperative neurophysiologic monitoring in asleep AVM resection: indication or redundancy? J Clin Neurophysiol. https:\/\/doi.org\/10.1097\/WNP.0000000000001214","journal-title":"J Clin Neurophysiol"},{"key":"7228_CR15","doi-asserted-by":"publisher","first-page":"299","DOI":"10.3340\/jkns.2024.0047","volume":"67","author":"JH Phi","year":"2024","unstructured":"Phi JH, Kim S-K (2024) Clinical features and treatment of pediatric cerebral cavernous malformations. J Korean Neurosurg Soc 67:299\u2013307. https:\/\/doi.org\/10.3340\/jkns.2024.0047","journal-title":"J Korean Neurosurg Soc"},{"key":"7228_CR16","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.wneu.2017.02.023","volume":"101","author":"J Roth","year":"2017","unstructured":"Roth J, Korn A, Bitan-Talmor Y, Kaufman R, Ekstein M, Constantini S (2017) Subcortical mapping using an electrified Cavitron UltraSonic aspirator in pediatric supratentorial surgery. World Neurosurg 101:357\u2013364. https:\/\/doi.org\/10.1016\/j.wneu.2017.02.023","journal-title":"World Neurosurg"},{"key":"7228_CR17","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s00381-019-04356-0","volume":"36","author":"J Roth","year":"2020","unstructured":"Roth J, Korn A, Sala F, Benvenisti H, Jubran M, Bitan-Talmor Y, Ekstein M, Constantini S (2020) Intraoperative neurophysiology in pediatric supratentorial surgery: experience with 57 cases. Childs Nerv Syst 36:315\u2013324. https:\/\/doi.org\/10.1007\/s00381-019-04356-0","journal-title":"Childs Nerv Syst"},{"key":"7228_CR18","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1007\/s00381-002-0582-3","volume":"18","author":"F Sala","year":"2002","unstructured":"Sala F, Krzan MJ, Deletis V (2002) Intraoperative neurophysiological monitoring in pediatric neurosurgery: why, when, how? Childs Nerv Syst 18:264\u2013287. https:\/\/doi.org\/10.1007\/s00381-002-0582-3","journal-title":"Childs Nerv Syst"},{"key":"7228_CR19","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1161\/STROKEAHA.121.035338","volume":"53","author":"AN Santos","year":"2022","unstructured":"Santos AN, Rauschenbach L, Saban D, Chen B, Herten A, Dinger TF, Li Y, Tippelt S, Della Marina A, Dohna-Schwake C, Schmidt B, Jabbarli R, Wrede KH, Sure U, Dammann P (2022) Natural course of cerebral cavernous malformations in children: a five-year follow-up study. Stroke 53:817\u2013824. https:\/\/doi.org\/10.1161\/STROKEAHA.121.035338","journal-title":"Stroke"},{"key":"7228_CR20","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1007\/s00381-017-3383-4","volume":"33","author":"A Shtaya","year":"2017","unstructured":"Shtaya A, Millar J, Sparrow O (2017) Multimodality management and outcomes of brain arterio-venous malformations (AVMs) in children: personal experience and review of the literature, with specific emphasis on age at first AVM bleed. Childs Nerv Syst 33:573\u2013581. https:\/\/doi.org\/10.1007\/s00381-017-3383-4","journal-title":"Childs Nerv Syst"},{"key":"7228_CR21","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-023-02099-w","volume":"46","author":"B Skrap","year":"2023","unstructured":"Skrap B, Di Bonaventura R, Di Domenico M, Sturiale CL, Auricchio AM, Maugeri R, Giammalva GR, Iacopino DG, Olivi A, Marchese E, Albanese A (2023) Has intraoperative neuromonitoring changed the surgery for unruptured middle cerebral artery aneurysms? A retrospective comparative study. Neurosurg Rev 46:191. https:\/\/doi.org\/10.1007\/s10143-023-02099-w","journal-title":"Neurosurg Rev"},{"key":"7228_CR22","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1016\/j.jocn.2011.01.033","volume":"18","author":"J Song","year":"2011","unstructured":"Song J, Qiao N, Xie L, Qiu T, Li P, Wu J, Zhu W, Chen L, He KM, Zhang N, Mao Y, Zhao Y (2011) Clinical features and microsurgical treatment of pediatric patients with cerebral cavernous malformation. J Clin Neurosci 18:1303\u20131307. https:\/\/doi.org\/10.1016\/j.jocn.2011.01.033","journal-title":"J Clin Neurosci"},{"key":"7228_CR23","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.nic.2013.05.001","volume":"23","author":"AK Toma","year":"2013","unstructured":"Toma AK, Davagnanam I, Ganesan V, Brew S (2013) Cerebral arteriovenous shunts in children. Neuroimaging Clin N Am 23:757\u2013770. https:\/\/doi.org\/10.1016\/j.nic.2013.05.001","journal-title":"Neuroimaging Clin N Am"},{"key":"7228_CR24","doi-asserted-by":"publisher","first-page":"304","DOI":"10.4103\/0028-3886.314528","volume":"69","author":"U Yeole","year":"2021","unstructured":"Yeole U, Gohil D, Shukla D, Bhardawaj S (2021) Removal of perirolandic cavernoma with direct cortical stimulation and neuronavigation with DTI. Neurol India 69:304\u2013306. https:\/\/doi.org\/10.4103\/0028-3886.314528","journal-title":"Neurol India"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07228-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-026-07228-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07228-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T01:12:18Z","timestamp":1774401138000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-026-07228-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7228"],"URL":"https:\/\/doi.org\/10.1007\/s00381-026-07228-6","relation":{},"ISSN":["1433-0350"],"issn-type":[{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"assertion":[{"value":"15 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures were performed in accordance with the principles outlined in the Declaration of Helsinki. Parents signed informed consent regarding procedures, data collection, and use. Ethical approval was waived by the Ethics Committee of Catholic University of Sacred Heart in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"131"}}