Although cancer is very rare in children, braintumors are the most frequent after leucemia.
The pediatric braintumors differ from those in adults in respect of localisation and pathology. Also the post-operative treatment is different due to the still developing brain in children and the specific characteristics of the tumors. Best care is given in high care children hospitals where interdisciplinarity of specialized neurosurgeons, neuropediatricians and neurooncologists is ensured.
Symptoms of a brain tumor may occur acute in the form of an epilectic seizure, or neurological deficits, i.e. paralysis – often of the eye movement. Often, the tumor causes gradual symptoms, such as headache, vomiting, increased fatigue, lack of concentration, or also behaviour changes. A loss of vision may occur progressively without being noticed by the child. In infants under 2 years, a general clinical deterioration occurs in most cases.
MRI scan is the first line examination to confirm the diagnosis and is the foundation for further treatment planning.
In many cases, a medical treatment with cortisone, to reduce the swelling of the brain, is started first and operation will be planned in order to remove the tumor or at least get a biopsy for histological diagnosis. All modern techniques are available in our institution. Depending on the definitive diagnosis and the age of the child, secondary treatment with radiotherapy and chemotherapy will be discussed.
Most common tumors in infancy are pilocytic astrocytoma or medulloblastoma of the cerebellum, the glioma of the optic nerve, the brain, brainstem and spinal cord, the ependymoma as well in the brain as in the spinal cord, germ cell tumours, craniopharyngioma.
The diagnosis of a brain tumor causes an immense psychological burden for the whole family. The fears of the little patients as well as of the parents and the siblings have to be taken care of within a psycho-social context. The hospitalisation, the surgery, the chemotherapy, and the radiotherapy cause not only a break down in daily routine, but also mean a permanent mental strain. The psychological and social care service of our childrens hospital conforms to the individual needs of the respective families.