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Brain and spinal cord tumors are the third most common type of childhood cancer, after leukemia and lymphoma.
The symptoms of childhood brain and spinal cord tumors are not the same as in adults or in every child. Post-operative CT scan showing a complete tumour resection (Histology was a€?mature teratomaa€™).
Picture showing the IGS and Intra-operative nerve monitoring set-up for brainstem surgery in a child with focal brainstem tumour.
MRI scan showing a intramedullary spinal cord tumour (arrowed) in the cervical spine, with the typical syrinx at the rostral and caudal aspects of the tumour. A HAIRDRESSER with a rare brain tumour has been left with robotic voices ringing in her ears making people sound like her greatest childhood fear - daleks. Who gets brain tumorsBrain tumors can develop at any age, but are most common in children between the ages of 3-12, and in adults aged 55-65. SurgerySurgery is the treatment of choice for accessible brain tumors, which can be removed without causing serious neurologic damage. Depending on the type of brain tumor, its location, and its size, a number of different techniques may be used to surgically remove it. Patients whose benign brain tumors can be completely removed may not require any additional treatment, but periodic physical and neurologic examinations and CT or MRI scans are sometimes recommended to determine whether the tumor has returned. Intraarterial chemotherapy uses tiny catheter tubes to delivery high-dose chemotherapy directly into the arteries of the brain. Potentially toxic chemotherapy drugs can be wrapped in special biologic envelopes called liposomes, to allow the drugs to be delivered to the tumor without adversely affecting other healthy tissues along the way.
When a young child has a brain tumor, chemotherapy is often used to eliminate or delay the need for radiation.Other treatmentsIf a brain tumor cannot be cured, treatment is designed to make the patient as comfortable as possible and preserve as much of his neurologic functioning as possible.
Potential therapiesScientists are studying ways to empower chemotherapy drugs to penetrate the blood-brain barrier (which protects the CNS by separating the brain from blood circulating throughout the body), and attack cancer cells that have infiltrated tissue inside it. Interleukin and interferon, which are substances produced naturally by the human immune system which seem to kill tumor cells. T-lymphocytes, which are also produced normally by the human immune system, and are being used to inject directly into the tumor location during surgery and to infuse into the bloodstream after surgery, in the hopes that they will boost the immune system's ability to fight tumor cells.
Tumor vaccines, which use elements of tumor cells to stimulate the patient's immune system.
Methods of incorporating chemotherapy drugs into tumor cells to reduce the need for radiation. Laboratory techniques that enable physicians to select the chemotherapy drugs most likely to kill particular types of tumors. Gene therapy in which genetically engineered material is transported to tumor cells by viruses that infect tumor cells and convert them to normal cells, stop their growth, or kill them.
Alternative treatmentAlternative treatments have not been shown to cure brain tumors and should never be substituted for conventional therapy.
Although these post-operative problems may initially be more severe than the symptoms produced by the tumor, they will probably diminish or disappear in time.Occupational therapy can teach patients and their families new ways to approach daily tasks.
Monthly self-examinations of the breasts and testicles can detect breast and testicular cancer at their earliest, most curable stages.ResourcesOrganizationsAmerican Brain Tumor Association. A 7 year old boy from Remote village presented with complains of vomiting 4-5 episodes per day for 3 months, inability to walk without support for 20 days and loss of vision in both eyes for 12 days. According to the parents, the child developed vomiting , without associated Nausea, which was aggravated in the morning after arising from bed. He complains of headache, tight in nature, more prominent in early morning and later localized to nape of the neck and was aggravated on movement of the head ( turning the head ). Child used to tilt his head and started complaining of loss of vision which progressed to complete blindness since last 10-12 days. Although the child has bladder and bowel sensation and parents have been helping him, he often passes urine and stool in bed. There is no history of frequency of micturation neither there is any complain of burning sensation or urgency.
There is no history of Loss of consciousness , seizure or any localized abnormal body movements. For this problem he had gone to Zonal Hospital where investigations were done – CT scan and Lumbar puncture done. But due to economical problem they presented late , ie after 2 months after the symptoms were severe  and disabiling. CN II Optic nerve- No perception of light, papillary reflex present bilaterally both direct and consensual. CN III,IV and VI- Extraocular movement could not be examined due to complete loss of vision. Motor system examination- Bulk, tone, power – Normal bilaterally, Gait- could not be tested, co-ordination-Normal, Reflexes were Normal. CT scan showed- dense white large infratentorial mass in the posterior fossa, in the midline occupying nearly 70% of the posterior fossa , without any calcification or hemorrhage. In children, most common locations are in the lower part of the brain, such as cerebellum and brainstem.
In certain cases, image-guidance systems (IGS) and intra-operative nerve monitoring are used to improve surgical results and outcome. In such cases, surgery is not advised and the treatment is usually radiation therapy, followed by immunotherapy. The scan image on the right shows the spinal cord after the tumour has been surgically resected.
Unlike other tumors, brain tumors spread by local extension and rarely metastasize (spread) outside the brain. Primary brain cancer is the second most common cause of cancer death between birth and the age of 34, and the fourth most common cause of cancer death in men aged 35-54. The antibodies are directed to find and attach to tumor cells, at which time the radioactive substance kills the tumor cell. Scientists seek to produce these substances in the laboratory and incorporate their use in brain tumor treatment. Physical therapy can benefit patients who have difficulty keeping their balance, expressing their thoughts, speaking, or swallowing. Headaches, epileptic seizures, vomiting + nausea, depend on the tumor location- problem with neurological functions. Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content. Vomiting was projectile in nature and 2-3 episodes per day, progressively increasing to 4-5 episodes per day.
Then he started having unsteadiness while walking , progressively leading to inability to walk without support.
After the reports were suggestive of Brain tumor- Medulloblastoma they referred him to Higher centre for further management 2 months back. Content (text, audio, video) on this website is only intended to provide general information to the reader and for academic purpose of medical students.
A benign brain tumor is composed of non-cancerous cells and does not metastasize beyond the part of the brain where it originates.
Primary tumors of the brain and central nervous system are often associated with HIV infection. Implant radiation therapy involves placing tiny pieces of radioactive material in the brain.
A brain tumor is considered malignant if it contains cancer cells, or if it is composed of harmless cells located in an area where it suppresses one or more vital functions.DescriptionEach year, more than 17,000 brain tumors are diagnosed in the United States.

They may spread throughout the brain, but rarely metastasize to other parts of the body.Mid-grade and high-grade tumors grow more rapidly than low-grade tumors. Left in place permanently, or for a short time, these radioactive pellets release measured doses of radiation each day. Hospices provide a supportive environment and help patients manage pain and remain comfortable.Consequences of radiation therapyCells killed by radiation can cluster in the brain, resembling tumors. The rest are malignant and invasive.Benign brain tumorsBenign brain tumors, composed of harmless cells, have clearly defined borders, can usually be completely removed, and are unlikely to recur. The growth pattern makes it difficult to remove the entire tumor, and these tumors recur more often than low-grade tumors.A single brain tumor can contain several different types of cells. Patients are usually hospitalized during the several days the pellets are most active.Stereoactic radiosurgery involves fitting the patient with a frame to stabilize the head, using imaging techniques to determine the exact location of tumor cells, and using a sophisticated instrument to administer radiation precisely to that point.
Benign brain tumors do not infiltrate nearby tissues but can cause severe pain, permanent brain damage, and death. The tumor's grade is determined by the highest-grade (most malignant) cell detected under a microscope, even if most of the cells in the tumor are less malignant. Children treated with radiation may lose some of their eyesight and develop learning problems. Benign brain tumors sometimes become malignant.Malignant brain tumorsMalignant brain tumors do not have distinct borders.
An infiltrating tumor is a tumor of any grade that grows into surrounding tissue.Types of brain tumorsGlioma is the term used to refer to the most prevalent primary brain tumors. Chemotherapy may be used with radiation and surgery as part of a patient's initial treatment, or used alone to treat tumors that recur in the same place or in another part of the body.
They tend to grow rapidly, increasing pressure within the brain (IICP) and can spread in the brain or spinal cord beyond the point where they originate.
Gliomas arise from glial tissue, which supports and nourishes cells that send messages from the brain to other parts of the body. The usual chemotherapy regimen for a brain tumor is a combination approach, most commonly using procarbazine, CCNU, and vincristine.New methods of delivering chemotherapy are being used as well.
It is highly unusual for malignant brain tumors to spread beyond the central nervous system (CNS).Primary brain tumorsPrimary brain tumors originate in the brain. 2 cranial nerves (nerves that go out of the brain itself) are responsible for sensory innervation the tongue- the glossofaringial (the inner third of the tongue) and a branch of the trigeminal nerve. Astrocytomas, ependymomas, and mixed gliomas are three of the most common gliomas.ASTROCYTOMAS.
Named for the star-like shape of their cells, astrocytomas can develop on any part of the brain or spinal cord. Accounting for 30% of all primary brain tumors, GBMs are the most common brain tumors in middle-aged adults. Because they contain a greater mixture of cells than any other brain tumor, they are the most difficult to treat.EPENDYMOMAS. Also called ependymal tumors, ependymomas account for 9% of all gliomas, and 5% of all intracranial tumors.
These tumors, which are most common in children and adolescents, begin in the very thin membranes that help form cerebrospinal fluid (CSF) and line the brain cavities (ventricles) that contain it.Ependymomas are usually benign, have well-differentiated borders, resemble normal cells, and grow very slowly. The cells of anaplastic (malignant) ependymomas look abnormal and grow more rapidly than the cells of benign tumors.MIXED GLIOMAS. These are rare tumors that usually occur in middle-aged adults, grow slowly, and do not usually spread beyond the part of the brain where they originate. These fast-growing, malignant tumors are now believed to originate in developing cells not normally present in the body after birth.
They are sometimes called primitive neurodectal tumors (PNET).MDL tumors are most common in children and are more common in boys than in girls.
MDL tumors usually originate in the cerebellum (the part of the brain that controls coordination and some muscle activity), and are often carried to other parts of the brain by cerebrospinal fluid.
The brain is a mass of soft, spongy, pinkish gray nerve tissue that weighs about 1.2 kg in a human being. It is connected at its base with the spinal cord, which is also part of the central nervous system.
Meningiomas, which represent more than 20% of all primary brain tumors, originate in the membranes that enclose the brain and spinal cord (meninges). Meningiomas grow so slowly that the brain can sometimes become accustomed to their presence. It contains nerve centers (groups of neurons and their connections) which control many involuntary functions, such as circulation, temperature regulation, and respiration, and interpret sensory impressions received from the eyes, ears, and other sense organs.
Meningiomas compress, rather than invade, brain tissue and may grow to be quite large before any symptoms appear.SCHWANNOMAS. It also contains centers or areas for associative memory which allow for recording, recalling, and making use of past experiences.Cerebrum.
These cells produce myelin, material that protects the acoustic nerve, which controls hearing.
The largest and main portion of the brain, the cerebrum is made up of an outer coating, or cerebral cortex, consisting of gray matter, several cell layers deep, covering the cerebral hemispheres. The cortex is the thinking and reasoning brain, the intellect, as well as the part of the brain that receives information from the senses and directs the conscious movements of the body.
In appearance the cortex is rather like a relief map, with one very deep valley (longitudinal fissure) dividing it lengthwise into symmetrical halves, and each of the halves again divided by two major valleys and many shallower folds. As the tumor progresses, it can press on the nerves that control movement and feeling in the face, and cause headaches and facial numbness or tingling. The patient may have trouble walking, swallowing, or controlling eye movements, and the sense of taste can be affected.
A Schwannoma that grows large enough to press on the brainstem can be deadly.CHILDHOOD BRAIN TUMORS.
The major senses of vision and hearing have been well mapped in the cortex; the center for vision is at the back, in the occipital lobe, and the center for hearing is at the side, in the temporal lobe.
Brain tumors that occur in children are described as supratentorial (in the upper part of the brain) or infratentorial (in the lowest part of the brain). Two other areas have been carefully explored, the sensory and motor areas for the body, which parallel each other along the fissure of Rolando. In the sensory strip are the brain cells that register all sensations, and in the motor strip are the nerves that control the voluntary muscles.
Infratentorial tumors include medulloblastomas, astrocytomas, and ependymomas.Causes and symptomsThe cause of primary brain tumors is unknown, but people who work with rubber and certain chemicals have a greater-than-average risk of developing them. In both, the parts of the body are represented in an orderly way.It is in the sensory areas of the brain that all perception takes place. There is no evidence that head injury causes brain tumors, but researchers are trying to determine the relationship, if any, between brain tumors and viruses, family history, and long-term exposure to electromagnetic fields.Symptoms do not usually appear until the tumor grows large enough to displace, damage, or destroy delicate brain tissue. Here sweet and sour, hot and cold, and the form of an object held in the hand are recognized. Here are sorted out the sizes, colors, depth, and space relationships of what the eye sees, and the timbre, pitch, intensity, and harmony of what the ear hears. The significance of these perceptions is interpreted in the cortex and other parts of the brain.
Remembering takes place at the same time as perception, so that other faces seen in the past, or experiences linked to that face are called up. For this type of association the cortex draws on other parts of the brain by way of the communicating network of nerves. When this area alone is stimulated, a particular event, a piece of music, or an experience long forgotten or deeply buried is brought to the individual's mind, complete in every detail.

When it is applied again, the memory begins again, not where it left off, but from the beginning. This is the stemlike portion of the brain connecting the cerebral hemispheres with the spinal cord, and comprising midbrain, pons, and medulla oblongata.
It is a relay station for body sensations, and integrates these sensations on their way to the cortex.
The thalamus is an organ of crude consciousness and of sensations of rough contact and extreme temperatures, either hot or cold. It is small (no larger than a lump of sugar), but takes part in such vital activities as the ebb and flow of the body's fluids and the regulation of metabolism, blood sugar levels, and body temperature. It directs the body's many rhythms, including those of activity and rest, appetite and digestion, sexual desire, and menstrual and reproductive cycles. It is the integrating center of the autonomic nervous system, with its sympathetic and parasympathetic branches, and is located close to the pituitary gland.
This contains a center for visual reflexes, such as moving the head and eyes, as well as a sound-activated center, obsolete in humans, for pricking up the ears. In the medulla, the great trunk nerves, both motor and sensory, cross over, left to right and right to left, producing the puzzling phenomenon by which the left cerebral hemisphere controls the right half of the body, while the right hemisphere controls the left half of the body. This portion of the brain also contains the centers that activate the heart, blood vessels, and respiratory system.
It is connected, by way of the midbrain, with the motor area of the cortex and with the spinal cord, as well as with the semicircular canals, the organs of balance. The function of the cerebellum is apparently to blend and coordinate motion of the various muscles involved in voluntary movements.
As a conscious function the cortex may, for example, direct the arm to pick up a glass of water; the cerebellum, which operates entirely below the level of consciousness, then translates this instruction into detailed actions by the 32 different muscles in the hand, plus several more in the arm and shoulder.
When the cerebellum is injured, the patient's movements are jerky and uncoordinated.Cranial Nerves. Between the middle and inner layer is a space filled with cerebrospinal fluid, which serves as a shock absorber. The brain is protected from harmful substances in the bloodstream by a barrier called the blood-brain barrier, which keeps some of the substances out of the brain entirely and delays the entry of others for hours or even days after they have penetrated the rest of the body. Other causes include compound fracture of the skull with contamination of brain tissue, sinusitis, and infections of the face, lung or heart.
Symptoms include fever, malaise, irritability, severe headache, convulsions, vomiting, and other signs of intracranial hypertension. Treatment consists of surgical removal of the infected area and administration of antibiotics.brain death the irreversible cessation of all brain activity for an appropriate observation period, at least 24 hours, so that cardiopulmonary functions must be artificially maintained.
Called also irreversible coma.brain scanning a nuclear medicine procedure for the detection of brain tumors, areas of stroke syndrome, abscesses, hematomas, and other intracranial lesions.
A radiopharmaceutical, such as 99mTc-pertechnetate, is injected intravenously and is carried to the brain, where it localizes around any lesion that alters the blood-brain barrier. A scintillation camera makes an image of the distribution of radioactivity in which a lesion appears as a region of increased activity. Computed tomography brain scanning is an alternative procedure, which is more effective than radionuclide scans for the detection of some lesions.brain tumor a neoplasm of the intracranial portion of the central nervous system. Any abnormal growth within the skull creates a special problem because it is in a confined space and will press on normal brain tissue and interfere with the functions of the body controlled by the affected parts.
Fortunately, the functions of certain areas of the brain are well known, and a disturbance of some specific function guides the clinician to the affected area. If diagnosed early, a benign tumor often can be removed surgically with a good chance of recovery. Some originate in the brain itself, while others metastasize from a tumor in another part of the body.The symptoms of brain tumor vary and depend on the location and size of the tumor. The headache can be generalized or localized in one part of the head, and the pain is usually intense. Disturbances of vision, loss of coordination in movement, weakness, and stiffness on one side of the body are also possible symptoms.
A tumor can also cause a distortion of any of these senses, such as seeing flashes at the sides of the field of vision, or smelling odors or hearing sounds that do not exist. Tumors are also called neoplasms, which means that they are composed of new and actively growing tissue. Their growth is faster than that of normal tissue, continuing after cessation of the stimuli that evoked the growth, and serving no useful physiologic purpose. Tumors of mesenchymal origin include fibroelastic tumors and those of bone, fat, blood vessels, and lymphoid tissue; they may be benign or malignant (sarcoma). Tumors of epithelial origin are found in glandular tissue and such organs as the breast, stomach, uterus, or skin; they also may be either benign or malignant (carcinoma). Benign tumors do not endanger life unless they interfere with normal functions of other organs or affect a vital organ. Benign tumors usually respond favorably to surgical treatment and some forms of radiation therapy.Malignant Tumors. They grow in a disorganized manner and so rapidly that nutrition of the cells becomes a problem.
They also invade surrounding tissues and are metastatic, initiating the growth of similar tumors in distant organs.
It may be accompanied by congenital defects such as urinary tract abnormalities, absent iris of the eye, and asymmetry of parts.
Called also embryonal carcinosarcoma and nephroblastoma.yolk sac tumor a malignant germ cell tumor of children that represents a proliferation of both yolk sac endoderm and extraembryonic mesenchyme.
It produces α-fetoprotein and most often occurs in the testes, but is also seen in the ovaries and some extragonadal sites. Called also endodermal sinus tumor.brain tumor an invasive neoplasm of the intracranial portion of the central nervous system. Brain tumors cause significant rates of morbidity and mortality but are occasionally treated successfully. In adults 20% to 40% of malignancies in the brain are metastatic lesions from cancers in the breast, lung, GI tract, or kidney or a malignant melanoma. The origin of primary brain tumors is not known, but the risk is increased in individuals exposed to vinyl chloride, in the siblings of cancer patients, and in recipients of renal transplantation being treated with immunosuppressant medication. Causes under investigation are genetic changes, heredity, ionizing radiation, environmental hazards, viruses, and injury. Symptoms of a brain tumor are often those of increased intracranial pressure, such as headache, nausea, vomiting, papilledema, lethargy, and disorientation, but vary depending on the site of a tumor. Diagnostic measures include visual field and funduscopic examinations, skull x-ray examinations, electroencephalography, brain scanning, magnetic resonance imaging, computed tomography, and spinal fluid studies.
Radiotherapy is indicated for inoperable lesions, medulloblastomas, and tumors with multiple foci and is used in postoperative treatment of residual tumor tissue.
The blood-brain barrier impedes the effect of some antineoplastic agents, but the administration of disk-shaped drug wafers is an emerging practice.
Postoperative nursing care includes assessment of the patient to detect elevation in intracranial pressure.

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