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Tumors of the brain in children
Last reviewed: 23.04.2024
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In children, 81-90% of brain tumors are intracerebral. In this case, they are more often than the middle line with respect to the structures of the brain (cerebellar worm, III, IV ventricles, brain stem). Supratentorial brain tumors prevail in children of the first year of life, whereas in the age group from 1 to 5 years - tumors of the posterior cranial fossa, among which the most common are medulloblastomas (in 2/3 cases - in boys). Tumors of the trunk constitute about 10% of all brain tumors in children. According to the histological type, about 70% of brain tumors in children have a neuroectodermal origin.
Primary neoplasms of the central nervous system are the most common solid tumors of childhood (16-20%). By frequency of occurrence they are inferior only to leukemia. In 95% of cases, neoplasms affect the brain.
Tumors of the brain in children in comparison with adults have a number of features. First of all, this is the high frequency of infratentrally located formations (2/3, or 42-70%, of brain tumors in children) with a predominant lesion (up to 35-65%) in the structures of the posterior cranial fossa. Among the nosological forms, the frequency is dominated by astrocytomas of different degrees of differentiation. Medulloblastoma, ependymoma and gliomas of the brain stem.
Symptoms of brain tumors in children
In newborns and young children, brain tumors are manifested by the development of progressive hydrocephalus, increased excitability, vomiting, decreased body weight growth, lag in psychomotor and intellectual development, edema of the optic nerve disk, decreased visual acuity, focal symptomatology, seizures.
In older children, the clinical symptoms of a brain tumor are characterized by the presence of headache, vomiting, dizziness, retardation in psychomotor and intellectual development, frequent lethargy and drowsiness, swelling of the optic discs, seizures and the appearance of paresis.
Focal symptoms of brain damage in children are often leveled by the pattern of hypertensive syndrome, which complicates the primary diagnosis of tumors. Often, tumors of subtentorial localization in children are masked for gastroenterological pathology, infectious diseases, helminthic invasions, etc.
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Diagnosis of brain tumors in children
Histological examination is the crucial method of verification of the diagnosis, which determines both the tactics (the amount of surgical intervention) and the strategy (prognosis, use of radiation therapy, chemotherapy, repeated surgical interventions) for the treatment of CNS tumors.
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Treatment of brain tumors in children
Surgery
The standard and key method of treating CNS tumors is surgical removal of the brain tumor. Over the past three decades, the survival of patients with CNS tumors has improved significantly due to the emergence of modern diagnostic methods (widespread magnetic resonance therapy with contrast enhancement), the improvement of neurosurgical techniques, neuroanesthesiology and resuscitation, and the improvement of accompanying therapy.
The leading role in the treatment of patients with brain tumors is played by neurosurgery. The operation allows to remove the tumor as much as possible and solve problems related to the mass effect (symptoms of intracranial hypertension and neurological deficit), that is, to eliminate the immediate threat to the life of the patient, and also to obtain material for determining the histological type of the tumor.