Clinical Characteristis Analyses Of Intracranial Tumor In Children

Objective: To investigate the clinical characteristics of childhood intra- cranial tumor,in order to make early diagnosis,get reasonable treament and improve prognosis.Methods: The age and sex distribution, location of tumor, clinical manifestation, imaging examinations and pathological examination, diagnosis and treatment of 98 children admitted into Children's Hospital of Chongqing Medical University from June 2003 to September 2008 were analyzed.Results: (1)In the cases studied, the age range was from 4 months to 14 years, the average age was (6.65±4.05) years,4 months~4 years, 5~10 years,11~14 years were accounted for 38.8%,42.9%,18.4% respectively; there were 63 males and 35 females,the gender ratio (male-to-female) was 1.8:1.(2)The tumors of 60 cases (61.2%) were located in posterior cranial fossa, while 14 cases ( 14.3% ) in cerebral hemisphere, 12 cases(12.2%) in s- ellar region, 6 cases(6.12%) in third ventricle, 4 cases(4.1%) in pineal region and 2 cases (2.04%) in thalamus.The most common intracranial tumors were medulloblastoms(30 cases, 30.6%),astrocytoma(26 cases, 26.5%),ependym- oma(17 cases, 17.3%),craniopharyngiomas (10 cases,10.2%) and germ cell tumors (4 cases,4.1%).(3)The main clinical manifestations were vomiting (61 cases, 62.2%), headache (58 cases, 59.2%), instability of gait or incoordination (38 cases, 38.8%),75 cases (76.5%) visited a doctor in the course of disease from 1 to 90 days,29 cases (29.6%) of the tumors were misdiagnosed.(4)Obstructive hydrencephalus was found in 78 cases (79.6%) by imaging examination, positive rate of tumor's diagnosis was 95.9%(94/98) and 100% by brain CT and MRI scaning respectively.(5)All the cases were operated on under general anesthesia, Before the tumor resection,34 cases with ventricular drainage , 5 cases with ventriculo peritoneal shunt , 79 cases (80.6%) improved, outside the hospital for further radiotherapy and chemotherapy; 11 cases (11.2%) automatic discharged; 8 cases (8.2%) died.Conclusions: (1)The incidence of 5 to 10 years old children was the highest in this group.And the incidence of boys was higher than girls.(2)Posterior fossa tumors were mainly in this group.The most common intracranial tumors were medulloblastoms, astrocytoma, ependymoma, cra- niopharyngiomas and germ cell tumors.(3)Intracranial tumors in childhood are mostly located in posterior cranial fossa with atypical clinical manifestations and short course of diseases. It is common to be misdiagnosed at early stage.Brain CT and MRI examinations are helpful for earlier diagnosis, which should be considered for the children when unreasonable increased intracranial pressure and localizing neurological sings exist.(4)Tumor resection maximatily and nerve function preserved is the first selection to cure childhood intracranial tumor, reasonable radiotherapy and chemotherapy are the main means of adjuvant therapy. With the development of molecular biology technology, imaging technology widely used,and various treatment methods improved, the prognosis of childhood intracranial tumor will be significantly improved.