Pediatric Brain Tumor
Introduction
Introduction to Pediatric Brain Tumors Brain tumors are the most common tumors in childhood, and the incidence of malignant diseases is second only to leukemia. All ages can be sick, but 5-8 years old is the peak of the disease. A variety of factors affect the occurrence of brain tumors. The incidence of certain brain tumors may be related to the deletion or mutation of specific genes. For example, all gliomas have chromosome 17p specific gene deletions, and highly differentiated gliomas also have chromosome 9p. Gene loss. Another example is meningioma and chromosome 10, medulloblastoma is associated with partial deletion of 17p chromosome. Pediatric brain tumors have their own characteristics and physiological characteristics of the body, so they have their own unique features in the treatment of pediatric brain tumors. In order to achieve good results, comprehensive active treatment is important. basic knowledge The proportion of sickness: 0.0052% Susceptible people: children Mode of infection: non-infectious complication:
Cause
Pediatric brain tumor etiology
Glioblastoma factor (30%):
Most common, including astrocytoma, ependymoma, and pleomorphic glioblastoma.
Primary neuroectodermal cell tumor factors (30%):
It belongs to undifferentiated progenitor cells, including medulloblastoma, adult pineal cell tumor and the like.
Intracranial tumor factors (20%) in which embryos participate in tissue formation:
Such as craniopharyngioma, skin and epithelioid cysts.
Other factors (20%):
From the point of view of the predilection, pediatric brain tumors occur in the lower (the posterior fossa) and brain midline structures more than adults. According to statistics, 2/3 of the intracranial tumors of children between the ages of 2 and 12 occur under the canopy. However, in children under 2 years old and over 12 years old, half of the screen and the curtain are half. At the same time, 75% of pediatric brain tumors occur in the third and fourth ventricles, and the midline structures such as the chiasm, cerebellar vermis or brainstem.
Prevention
Pediatric brain tumor prevention
1. Do not eat too much salty and spicy food, do not eat too hot, too cold, should supply protein foods that are easy to digest and absorb, such as milk, eggs, fish, soy products, etc., can improve the body's anti-cancer power. Pay attention to food hygiene, do not eat contaminated food, such as contaminated water, crops, poultry, eggs, moldy food, etc., eat some green organic food, to prevent disease from mouth. Eat more anti-cancer foods, such as Cordyceps, turtle, mushrooms, black fungus, garlic, seaweed, mustard and royal jelly. Eat more foods containing vitamins A and C, which can increase the stability of epithelial cells. Vitamin C can also prevent the general symptoms of radiation damage and increase the level of white blood cells; therefore, you should eat more foods rich in vitamins, such as fresh Vegetables, fruits, sesame oil, cereals, beans and animal offal.
2, a healthy lifestyle can also effectively prevent the occurrence of brain tumors in children. At home, you must quit smoking to prevent second-hand smoke from harming children. The World Health Organization predicts that if people no longer smoke, after five years, the world's cancer will be reduced by one-third. Second-hand smoke is especially important for children.
3, to avoid harmful substances (promoting factors) can help us avoid or minimize exposure to harmful substances; experts pointed out that 90% of malignant tumors are caused by environmental factors.
Complication
Pediatric brain tumor complications Complication
Cerebral palsy: When there is a space-occupying lesion in a certain cavity in the normal cranial cavity, the pressure of the sub-chamber is higher than that of the adjacent sub-chamber. The brain tissue is displaced from the high-pressure area to the low-pressure area, and is squeezed into a nearby physiological hole or non- Physiological channels cause partial compression of brain tissue, nerves and blood vessels, and cerebrospinal fluid circulation disorders occur to produce a corresponding symptom group called cerebral palsy. Cerebral palsy is caused by a sharp increase in intracranial pressure. In the diagnosis of cerebral palsy, high-osmotic intracranial pressure drugs should be rapidly infused according to the principle of increased intracranial pressure to relieve the disease and gain time.
Symptom
Symptoms of brain tumor in children Symptoms Symptoms of episodes of intracranial hypertension epilepsy, disturbance of consciousness, ataxia, irritability, vaginal edema, vomiting
Most of them present a clinical process of chronic or subacute progressive aggravation, and their clinical manifestations can be classified into two types: cranial hypertension and tumor focal symptoms:
1, intracranial hypertension symptoms
These include headache, vomiting, and papilledema. Infants do not complain of headaches, mainly showing fullness of the front, cranial sutures, enlarged head circumference and broken head sounds. The headache is initially intermittent, and can be converted into persistent with paroxysmal aggravation, and the whole brain or frontal or occipital part. Headache and vomiting are often more severe in the morning, and there may be a brief relief of headache after vomiting. Increased intracranial pressure can also cause secondary optic atrophy and loss of vision.
Children often have elevated blood pressure, slow pulse, hyperactivity, irritability, and lack of energy. If there is a large pupil or obvious disturbance of consciousness, the cerebral hiatus should be considered. In the case of irregular breathing rhythms and stiff neck, consider concomitant occipital foramen.
2, symptoms and signs
Due to the location and size of the tumor, it is common to:
(1) limb paralysis: cerebral hemisphere tumors can cause hemiplegia with pyramidal tract sign positive, brain stem tumors cause cross-caries, ie, ipsilateral cranial nerve or subnuclear sputum, and contralateral limb palsy.
(2) seizures: seen in cerebral hemisphere tumors, with focal or total seizures.
(3) Ataxia: gait sputum, often accompanied by nystagmus, more common in cerebellar tumors.
(4) vision loss and visual field defect: cranial tumor and other tumors in the sellar region of the sellar tumor, but the optic nerve atrophy and visual field loss.
(5) hypothalamic and pituitary dysfunction: the tumor in the sella region or the anterior horn of the third ventricle may cause growth and development, precocious puberty, urinary complications or obesity.
Examine
Pediatric brain tumor examination
In children with progressive intracranial hypertension, or related focal signs and symptoms, attention should be paid to the possibility of intracranial tumors.
Skull imaging is the key to further diagnosis. Computed tomography (CT) can help most patients with obvious diagnosis, but the tumor in the posterior fossa is affected by the overlap of the skull base and the resolution is not as good as magnetic resonance imaging (MRI). The latter is clearer than CT imaging and has a clear anatomical display in the brain. Therefore, the diagnostic advantages of the midline structure and posterior fossa lesions are outstanding, but the display of calcification and bone is not as good as CT.
Other examinations: 1 skull X-ray film: can understand the presence or absence of cranial suture separation, craniocerebral pressure and other signs of increased intracranial pressure, but also visible tumor calcification spots or enlargement of the sellar region. 2 lumbar puncture: mainly used for the identification of internal infectious diseases, but the significant increase in intracranial pressure has the risk of cerebral palsy, should be appropriate to reduce the intracranial pressure before considering lumbar puncture.
Diagnosis
Diagnosis and diagnosis of brain tumor in children
In some brain tumors, such as medulloblastoma or periventricular tumors, cerebrospinal fluid can be mistaken for infectious "white blood cells" due to tumor shedding cells, but careful cell morphology can make a difference. Some children with brain tumors have a regenerative diagnosis. The use of hormones, dehydrating agents or other symptomatic treatments can temporarily improve intracranial hypertension or localization, and should not be misdiagnosed as other diseases such as intracranial infection. When the posterior fossa tumor or severe intracranial pressure is increased, there may be neck resistance. Do not mistake the meningeal irritation.
