Pediatric Brain Tumors Research Paper.docx - michellebovee1 ...
Pediatric Brain Tumors
Anatomy & Physiology
November 28, 2008
Pediatric Brain Tumors
Brain tumors can occur at any age and are most common in children.
Seventy-six percent of children with brain tumors are under the age of 15 years
old and each year there are approximately 3400 new cases diagnosed.
There are 120 different types of brain tumors so it is hard to find treatment
for all of the different ones there are. Sixty percent of childhood tumors are
located in the posterior fossa (the back of the brain). The posterior fossa includes
the cerebellum, brainstem and the fourth ventricle. The different kinds of tumors
in this area are called medulloblastomas, cerebellar astrocytomas, brainstem
gliomas, and ependymomas.
The remaining forty percent of tumors occur within the two cerebral
hemispheres or the spinal cord. The most common tumors that occur in the
spinal cord are astrocytomas and ependymomas.
The cause of most brain tumors is not known, researchers are
looking into environmental and genetic factors for clues. Doctors believe that the
majority of the tumors are caused by abnormal, uncontrolled cell growth.
Tumors, also called Neoplasms, are made up of primary cells. Brain and
spinal tumors in children are primary cells or secondary cells. Primary means that
they start at the central nervous system (CNS) and usually never spread beyond
the brain and spinal cord. Secondary tumors spread to the brain from
somewhere else in the body.
The central nervous system consists of the brain and the spinal cord. The
brain controls thought, memory, respirations, temperature, hunger, emotions,
touch, vision and motor skills
There are benign and malignant tumors. Benign do not spread at all, are
slow-growing, and usually non-cancerous. Malignant tend to be cancerous, fast-
growing, can invade surrounding tissues and can recur anytime after treatment.
Benign tumors can be very critical if it is growing in the brain stem or if it is
a large enough mass to put pressure on areas of the brain. Some circumstances,
benign tumors may change and turn into malignant tumors.
. The brain and spinal cord are located in the skull and spine; tumors are
noticed more likely because the limited amount of space. As the tumor begins to
grow and expand, it will put intracranial pressure on the head or spine due to
blockage of cerebrospinal fluid. The blockage of the fluid is called hydrocephalus,
excess fluid on the brain, which then leads to many types of noticeable
symptoms or effects
Some of the many signs and symptoms of intracranial pressure are,
headaches, which are most likely in the morning time, vomiting or nausea,
balance difficulty or body weakness, blurred or changes in vision, seizures
,memory loss, behavior or mood changes and speech difficulties.
Spinal cord tumor symptoms may have pain sensations, which is more
noticeable at nighttime while the child is at rest, tingling or weakness of legs and
arms and urinary incontinence.
A physician or any caregiver that suspects a brain tumor will have the
patient undergo either a CT scan or MRI of the brain or undergo both
procedures. Using these two different procedures, doctors can pinpoint the exact
location of the tumor.
Often medical professionals will order the child to be sedated during an
MRI, they are required to be very still for a long time, and any type of movement
can cause the film to be blurred, making it difficult to review the image.
After the imaging scans are complete, a specialist will look over the scans
and if a tumor is present, the next steps would be removal of the tumor. Other
tests that may be performed are an EEG and an examination of the cerebral
The typical treatments for primary pediatric brain tumors are surgery,
removal of the brain tumor or part of the tumor, also called resection. After
surgery, the patient within two days will have a follow-up MRI to provide a
baseline to compare future MRI scans. Some tumors after surgery will not
require any other type of treatment, while tumors that are more aggressive, other
types of treatment are used.
Common treatments that are used are: Radiation therapy- the use of high-
energy light rays to kill dividing or multiplying cells. Chemotherapy- the use of
drugs to kill cancer cells through an IV catheter. Chemotherapy has less long-
term effects than radiation does.
Medications that are used after surgery are Corticosteroids, which help to
reduce swelling and intracranial pressure. Diuretics are used to reduce the
buildup of excess fluid in the brain. Anti-convulsants are used to reduce or
prevent seizures. Also pain medications are used to help control pain that may
be associated after the surgery.
Other treatments that are typically used would be physical therapy,
occupational therapy, neurological testing, vision and auditory testing.
Also, MRI scans done every few months to keep track of any new tumor
growth, regularly scheduled visits with a Pediatric Oncologist, Pediatric
Neurologist and Pediatric Psychologist just to name a few.
Physical & Mental Affects
There are many changes and effects to the patient after the removal of the
tumor and all the treatments that have been done. Some of the effects are
changes in the physical appearance. For children, changes in appearance may
lead to a negative self-image.
Some of the changes or effects are, hair loss due to chemotherapy or
radiation therapy, hair loss can be permanent if the patient received whole- brain
radiation. Other effects from radiation, chemotherapy, and brain surgery are the
cognitive and/or sensory problems that may result in learning difficulties.
Learning difficulties may result in being easily fatigued, hearing or vision
problems and coordination problems. These types of difficulties make learning
much harder for the patient and may need special education services while
Neurocognitive problems are the other effects that result from brain
tumors. The areas that are affected are usually decreased intellectual ability,
memory and attention difficulties and poor academic performance. Children
under the age of 7 are usually the ones at risk for these changes.
A small number of tumor survivors can develop heart, kidney, lung and
skeletal problems or even new tumors may develop.
It is critical that the patient works with a long-term provider that deals with
his or her condition to monitor any possible future tumor re-growth. By doing so,
the patient can then live life knowing their condition is somewhat controlled.
The reason I chose to do this report is that I went through all of this with
my son and am very familiar with it all and would like others to know the signs
and symptoms of these tumors.
November, 2005, my son’s eye was crossing over so I brought him to an
eye doctor Dec 2, 2008, which right away they ordered a MRI to see what the
cause was of his sudden eye crossing. The MRI showed there was intracranial
pressure on his head which put pressure on his eye to make it cross over. My
son was rushed to the U of M neurosurgeons, and had an Ependymoma brain
tumor removed December 5, 2005. My son still currently gets check-ups, MRI’s
every 4 four months, vision and hearing tests every 6 months. He is currently still
dealing with the alopecia as a result of the radiation therapy that he had to
undergo for 2 months back in January-February 2006. So far he has not had any
reoccurrences and is going to his appointments and is doing fine.
Children’s Brain Tumor Foundation (2003) Pediatric Brain Tumors: A Resource
Guide For Parents of Children with Brain or Spinal Cord Tumors,
Buckner JC, Brown PD, O'Neill BP, Meyer FB, Wetmore CJ, Uhm JH. Central
nervous system tumors. Mayo Clin Proc. Oct 2007;82(10):1271-86.
Retrieved on November 15, 2008, from
Detailed Guide: Brain/CNS Tumors in Children: What Are Brain and Spinal Cord
Tumors in Children? , Revised 04/07/2008. Retrieved on November 15,
2008 from The American Cancer Society,