- 14 August 2019
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Brain Tumours in Children: Symptoms, Diagnosis, and Treatment
Has your child started using a mobile phone regularly? Does anyone in your family has a history of brain tumour, and are you worried that your child might inherit the same? This blog, provided by Sunshine Hospital Hyderabad, may help you understand brain tumours in children, types of brain tumours, causes, symptoms, diagnosis, and treatment. If your child is diagnosed with a brain tumour, you need to know that there are various types of brain tumours based on their size and shape, composition, growth rate, location, age of the child, and general health condition of the child. The name and classification of a tumour may change over the course of treatment if the treating doctor comes across further information about the tumour. Brain tumours in children often occur in the brain or surrounding structures of the brain.
What is a Brain Tumour?
Brain tumours are relatively rare in children, and the chances of a tumour occurring in children are as low as 5 out of every 100,000 children. Although brain tumours in children can be benign (non-cancerous) or malignant (cancer), both can be life-threatening. However, children with brain tumours usually have a better prognosis than adults with similar conditions.
Benign brain tumours: These type of tumours are non-cancerous and usually do not recur after removal. Most benign brain tumours have clear boundaries, which means they do not attack the surrounding tissue. However, due to its size and location in the brain, these types of tumours can produce symptoms similar to those caused by cancerous tumours.
Malignant brain tumours: These type of tumours are cancerous in nature. Malignant tumours of the brain usually develop rapidly and attack the surrounding tissue. Malignant brain tumours spreading to the surrounding structures are rare but can recur after treatment. Sometimes, non-cancerous brain tumours are said to be malignant because of their size and location, and the damage they can do to vital brain functions. Brain tumours can occur at any age. Brain tumours that occur in infants and children are very different from adult brain tumours, both in terms of cell type and response to treatment. Most brain tumours have abnormalities in the genes involved in cell cycle control, resulting in uncontrolled cell growth. This disorder is caused by a direct change in the genes or by chromosome rearrangement that changes gene function. Brain tumours usually depend on the type of tumour, its location in the brain, its spread, and the age and general health of your child. It is mostly treated with surgical procedures and other therapies, including chemotherapy and radiation. Now a day for some of the specific genetic mutations that occur in childhood brain tumours, they begin to develop targeted treatments (precision drugs) that can be used to treat brain tumours. Treatment of brain tumours in children is different when compared with the treatment of adult brain tumours. Therefore, it is essential to take the help of the expertise and experience of pediatric neurologists and cancer specialists.
We at Sunshine Hospital Hyderabad provided you, well-experienced doctors, so meet our doctor if you have any doubts regarding your child’s health.
Causes and Risk Factors of Brain tumours in Children:
In most cases, the exact cause of a child’s brain tumour is unknown. Doctors don’t know what causes brain tumours, but researchers believe that:
Genetic: Some children with certain genetic disorders have a higher chance of developing brain tumours. Diseases such as neurofibromatosis, von Hippel-Lindau disease, and Li-Fraumeni syndrome are associated with a higher risk of brain tumours.
Chemicals: Can change the structure of genes that protect the body from disease and cancer. The study looked at parents of children with brain tumours and their previous exposure to certain chemicals, including pesticides and petroleum products.
Radiation is the only known environmental risk factor: This is usually the result of medical treatment for other conditions. Radiotherapy, CT, and head X-rays increase the risk of tumours. Electromagnetic radiation from cellphones and power lines has been investigated as a potential risk factor. However, the researchers found no convincing evidence to link these things to childhood brain tumours.
Symptoms Of Brain Tumour in Children:
Tumours in infants, children, and adolescents: It is important to note that specific symptoms, their severity, and whether they develop suddenly or gradually, depends on many factors. Also, some brain tumours cause no symptoms and are only detected after diagnosis. Many other conditions can also cause these symptoms. Consult a pediatrician if your child has one or more of them.
- Increased head size in infants
- Drowsiness, listlessness or irritability
- Frequent severe or worsening headaches, especially in the morning or in the middle of the night
- Sudden or persistent vomiting, usually in the morning
- Impaired growth
- Weakness in the face, arm, or on one side of the body
- Changes in behavior, personality or mood
- Numbness or tingling in arms, and legs
- Abnormal head tilt, body positions or movements
- Problems with walking, balance, breathing, speaking or swallowing
- Bowel or bladder problems
- Problems with vision or hearing
- Early puberty
- Confusion, irritability
- Memory problems
Types of Brain Tumours: There are many types of brain tumours. Some of them are cancer (meaning they can spread to body parts outside the brain), others don’t. Doctors categorize tumours based on location, type of cell affected, and growth rate. Tumours are grouped into these categories:
Low-grade vs. high-grade: Low-grade tumours usually develop slowly, while high grade tumours grow rapidly and may be cancerous. High grade tumours can attack tissues that are adjacent or spread to other parts of the body (metastasis) and tend to reappear after treatment to remove them. High-level tumours are usually associated with a worse prognosis.
Local Vs. Invasive: Localized tumours are limited to one area and are usually more easily removed as long as the tumour is in a brain part that can be easier to remove. Invasive tumours have spread to the environment and are more difficult or impossible to eliminate.
Primary vs. Secondary: Primary brain tumours begin in the brain. Secondary brain tumours consist of cells that metastasize in the brain from other locations in the body. In children, most brain tumours are primary. When brain cells grow abnormally or out of control, a tumour(cell mass) can form. If the tumour puts pressure on specific areas of the brain, it can affect body function. If tumours found early enough, then brain tumours are usually treated. Many of those who develop slowly are treated with surgery alone. Other tumours that grow faster may require additional radiotherapy or chemotherapy or both.
In children, some common types of primary brain tumours are:
- Brainstem gliomas
- Medulloblastomas or primitive neuroectodermal tumours (PNETs)
- Germ cell tumours
- Pontine gliomas
- Optic nerve gliomas
- Pineal region tumours
How Are Brain tumours Diagnosed in Children?
In addition to a complete history and physical examination of your child, brain tumour tests can include:
Neurological Examination: The pediatrician tests reflexes, muscle strength, eye, and mouth movement, coordination, and alertness.
Magnetic resonance imaging (MRI): A diagnostic procedure that uses a combination of magnets, radio frequencies, and computers to obtain detailed body images. MRI is useful for observing the brain tumours.
Computed Tomography: Also known as a CT scan or a CT. It is a Diagnostic imaging technique a combination of X-rays and computer technology to produce horizontal or axial images. CT shows detailed images of all parts of the body, including bones, muscles, fat, and organs such as the brain. CT is more accurate than general X-rays.
X-rays: A diagnostic test that uses a beam of electromagnetic energy that is not visible to make images of internal tissues, bones, and organs in the film.
Angiogram: In an angiogram use of dye to visualize, all the blood vessels in the X-ray brain are visualized to detect certain types of tumours.
Myelogram: X-ray of the brain, similar to an angiogram.
Puncture / lumbar spine: Use of special needles in the lower back of the spinal canal. This is the area around the spinal cord, where small amounts of cerebrospinal fluid (CSF) can be removed and sent for testing. CSF is a fluid that helps to diagnois the brain and spinal cord tumours.
Positron emission tomography (PET): A diagnostic technique in nuclear medicine that measures cell metabolic activity. PET scanning can indicate areas of cancer that cannot be seen during CT or MRI scanning.
Biopsy: Removal of tissue samples to be examined (biopsy) can be done as part of removing brain tumours. If a brain tumour is difficult to reach or in a sensitive area that can be damaged by prolonged surgery, a stereotactic needle biopsy can be done. Pediatric neurosurgeons drill a small hole in the skull, insert a thin needle through a hole, and lift the tissue with a needle. Biopsy samples were analyzed in the laboratory to determine the cell type and their level of aggression.
Tests whether cancer has spread: If it is suspected that your child’s brain tumour is caused by cancer that has spread from other parts of the body, the doctor may recommend tests and procedures to determine where cancer begins. Brain tumour tests mainly depend on the type of cell where the tumour begins and where the tumour is located.
Treatment of Brain tumours in Children: Treatment can vary depending on the nature of the tumour, location, age of the child, and many other factors. Treatment plans can include a combination of anti-tumor therapy. Caregivers for your child can also manage all the side effects of treatment. If your child is diagnosed with a brain tumour, you can ask for a second opinion before starting treatment. A pediatrician will determine specific treatment of brain tumours according to the following criteria:
- Child’s age, general health, and medical history
- Type, location, and size of the tumour
- Level of disease
- Child’s tolerance for drugs, procedures or certain therapies
- Your opinion or preference
Treatment may include (alone or in combination):
- Surgery: In the treatment of brain tumours, it is usually the first step. The goal is to remove as many tumours as possible while maintaining neurological function. Biopsy surgery can also be done to check the cell type from which the tumour is made for diagnosis. This is often done when the tumour is in the area of the soft or sensitive structure that can be injured.
- Radiation therapy
- Bone marrow transplantation
- Steroids are used to treat and prevent swelling especially in the brain)
- Anti Seizure medication is used to treat and prevent seizures associated with intracranial pressure
- Ventriculoperitoneal shunt: Can be placed on the head to drain excess fluid from the inside of the brain to the stomach. VP shunt helps control pressure in the brain.
- To prevent the side effects of the tumour or treatment child requires Supportive care
- To regain lost motor skills and muscle strength Rehabilitation is used as a treatment
- To treat and prevent infections, doctors will prescribe Antibiotics.
- Continuous follow-up care with a doctor to manage the disease, detect recurrence of the tumour and to manage late effects of treatment.
The Brain Cancer Center at Sunshine Hospital Hyderabad is a known name in treating children with malignant and non-malignant brain tumours. Get you to know our brain tumour specialist here. Finally, no matter how difficult it is, try to take care of yourself. Parents who receive the support they need can better support their children.
Conclusion: Brain tumours in children is a rather rare condition. Brain tumours in children are quite different from those found in adults in terms of their cell composition and their response to treatment. The types of pediatric brain tumours vary in terms of their size, location, the rate at which they grow, age of the child, and his/her overall general health. There are various modes of diagnostic treating to detect the presence of a tumour. Detecting the tumour in the early stages of its growth gives ample time for the treating doctor to treat the tumour effectively. Treatment options are available for treating the tumours; the treating doctor would choose the right combination of treatment modalities after assessing the tumour and the child’s health. Please schedule an appointment with our pediatric neuro-oncologists for any further queries you may have in this regard. We can be reached at 04044550000.
About The Doctor:
Dr Naveen is an expert in treating patients with a brain tumour. He is one of the best neurosurgeons in Hyderabad and is sought after for some of the most delicate and complicated brain surgeries.
About Sunshine Hospitals: A Multi Super Speciality Institution, 500 bedded Sunshine Hospitals (Paradise Circle, Secunderabad) is promoted by globally reputed Joint Replacement Surgeon Dr AV Gurava Reddy (Orthopedic Doctor) and like-minded associates who share the objective of making world-standard healthcare available, affordable and accessible to the common man. Sunshine has now become one of the best hospitals for many treatments including Orthopedic, Gastroenterology, Cardiology, Trauma and Neurology.