Makindo Medical Notes

> Brain tumours are the most common solid tumours in children and represent a significant portion of pediatric cancers. They can develop in various parts of the brain and spinal cord, often presenting with a wide range of symptoms. Advances in medical imaging, treatment, and supportive care have improved outcomes for many children diagnosed with these conditions.

Common Types of Paediatric Brain Tumors

• Medulloblastoma: A fast-growing tumour commonly located in the cerebellum, responsible for balance and coordination.
• Astrocytoma (including Pilocytic Astrocytoma): A tumour that arises from star-shaped brain cells called astrocytes, often slower-growing and more treatable when low-grade.
• Ependymoma: A tumour originating from ependymal cells that line the fluid-filled spaces of the brain and spinal cord, potentially affecting cerebrospinal fluid flow.
• Brainstem Glioma (including Diffuse Intrinsic Pontine Glioma, DIPG): Tumors occurring in the brainstem, a critical area controlling many vital functions, which can be challenging to treat.
• Cranipharyngioma: A slow-growing tumour near the pituitary gland that can affect hormones, growth, and vision.

Symptoms: depending on the tumour’s location and size

• Headaches, often worse in the morning
• Nausea and vomiting
• Vision or hearing changes
• Problems with balance or coordination
• Seizures
• Behavioral changes or cognitive difficulties

Diagnosis

Diagnosis typically involves a combination of imaging tests (MRI, CT scans), neurological exams, and sometimes a biopsy to determine the tumour’s specific type. In many cases, a multidisciplinary team—including pediatric oncologists, neurosurgeons, radiologists, and neurologists—works together to identify the best approach for each child.

Treatment Options

Treatment plans for pediatric brain tumours are tailored to the individual, considering factors like tumour type, location, and the child’s overall health. Common treatments include:

• Surgery: Removal or reduction of the tumour, when possible, to alleviate pressure and reduce tumour burden.
• Radiation Therapy: Targeted radiation can help shrink or control tumour growth, often used in combination with other treatments.
• Chemotherapy: Medications designed to kill or slow the growth of cancer cells, sometimes used before or after surgery or radiation.
• Targeted Therapies: Newer treatments that focus on specific mutations or pathways in tumour cells, minimizing damage to healthy tissue.
• Supportive Care and Rehabilitation: Physical, occupational, or speech therapy, alongside educational support, helps children cope with side effects and maintain quality of life.

Outlook and Research

Many children with brain tumours can achieve remission or long-term survival, especially with early diagnosis and multimodal treatment. Ongoing research focuses on developing more effective and less invasive therapies, improving early detection methods, and mitigating long-term side effects. Through continued advances, there is hope for better outcomes and improved quality of life for children affected by brain tumours.