[Precautions During Pediatric Neurosurgery].

Pediatric patients are not simply small adults; pediatric neurosurgical care requires specific considerations based on developmental anatomy, physiology, and psychosocial contexts. This review summarizes the practical points frequently encountered by early career neurosurgeons, focusing on clinical assessment, imaging, and perioperative management. Clinical presentation varies markedly with age: infants often exhibit nonspecific signs, such as poor feeding, irritability, or progressive head enlargement, whereas school-aged children may report headaches, nausea, gait disturbance, or behavioral changes. Imaging should prioritize low invasiveness and radiation exposure. MRI is preferred when feasible; however, sedation is often required in infants and young children, and safe practice should follow the established recommendations regarding fasting, airway risk assessment, and monitoring. Perioperative management includes weight-based fluid and medication dosing, judicious prophylactic antibiotics, and meticulous intraoperative care. Particular attention is required to prevent hypothermia, airway complications during positioning, pressure injuries, adhesive-related skin damage, and head-fixation-related complications in patients with thin cranial bones. Finally, building trust with caregivers is essential. Clinicians should recognize the profound burden of discussions about diagnosis and surgery and continuously refine their communication skills to deliver bad news.