Severity of a brain tumour in children is based on certain factors, like, the tumour size, it’s location and most importantly, it’s grade
Severity of a brain tumour in children is based on certain factors, like, the tumour size, it’s location and most importantly, it’s grade. Low grade tumours (I or II) are slow growing tumours while the high-grade tumours (III or IV) are malignant and fast growing ones; if not treated in time these can often prove to be fatal.
The most common type of brain tumours prevalent among children are gliomas and medulloblastomas.
Gliomas arise from glial cells which are the supportive tissue of the brain. Depending on their site of origin, these gliomas are categorised as:
*Astrocytomas
*Brain Stem Gliomas
*Ependymomas
*Optic Nerve Gliomas
Astrocytomas
These are the most common type of gliomas found in children between 5-8 years. Infact, about half the pediatric brain tumours fall in this category. These develop from glial cells called astrocytes and are commonly located in the cerebrum or the cerebellum. Depending on their grade, astrocytomas can either be slow-growing or fast-growing tumours.
These are further sub divided into four primary types:
*Juvenile pilocytic astrocytoma (Grade I): This slow-growing tumour is the most common brain tumour found in children. This is usually cystic and develops in the cerebellum.
Surgical removal is often the only treatment necessary to treat this grade I type.
*Fibrillary astrocytoma (Grade II): This brain tumour enters into the surrounding normal brain tissue, thereby making surgical removal difficult.
*Anaplastic astrocytoma (Grade III): This brain tumour is malignant and often shows symptoms such as weakness, unsteady walking and numbness.
*Glioblastoma multiforme (Grade IV): This is the most malignant type of astrocytoma and it grows rapidly while increasing pressure inside the brain
Brain Stem Gliomas
These gliomas are tumours found in the brain stem, a delicate location where many pathways from the brain to the spinal cord travel.
These tumours occur almost exclusively in children; majority in school going children. The child may experience problems such as double vision, or difficulty with walking and coordination, etc. Tumours located in the middle of the brainstem cannot be surgically removed.
Ependymomas
These tumours develop either in the lining of the ventricles of the brain or even in the spinal cord.
Ependymomas often block the flow of the cerebral spinal fluid, which bathes the brain and spinal cord causing increased intracranial pressure. These can be slow growing, compared to other brain tumours, but may recur after the treatment is completed.
Optic Nerve Gliomas
These are found in or around the nerves that send messages from the eyes to the brain. They are frequently found in children born with neurofibromatosis. As a result of this tumour, a child may experience loss of vision or hormone problems. It can be challenging to treat these tumours.
Medulloblastoma
These are among the most common malignant brain tumours and account for about 15% of brain tumours found in children between the age group of 4-9 years.
Medulloblastomas form in the cerebellum. They are named after the medulla, which connects the bottom of the brain to the top of the spinal cord. These tumours have tendency to spread to the spine or other parts of the body.
Medulloblastomas usually affect boys more frequently than girls.
Other Brain Tumours In Children:
* Choroid plexus tumour
* Craniopharyngioma
* Dysembryoplastic neuroepithelial tumor
* Germ cell Tumour
Brain Tumour Sites:
Paediatric brain tumours commonly occur inside:
* Cerebellum: the lower, back part of the brain, which controls balance, coordination and fine muscle control, eg, walking.
* Cerebrum: the large, outer part of the brain, which controls thought, learning, speech, emotions, muscle movements, etc.
* Brainstem: the bottom part of the brain, which connects the cerebrum to the spinal cord and controls numerous body functions and their movement.
Common Symptoms and Diagnosis
The common symptom of a childhood brain tumour may be persistent headaches. However, in case of any of these below listed symptoms, it is advisable to see a paediatrician or a specialist immediately.
* Morning headache
* Frequent nausea/vomiting
* Vision, hearing, speech problems
* Loss of balance
* Personality changes
* Seizures
* Increased head size in infants
Doctors may diagnose brain tumours on the basis of a physical and neurological exam, lab tests, and imaging reports, etc.
Treatment for children is sometimes different than what is recommended for adults. However, treatment option strictly depends on the type of tumour and its location.
Three types of standard treatment used to treat paediatric brain tumour includes:
#Surgery: Minimally invasive surgery may be used to treat and remove childhood brain tumours. At times it can be tricky though.
#Radiation therapy: This cancer treatment uses high-energy x-rays or other types of radiation to kill/eradicate cancer cells.
There are two types of radiation therapy:
*External radiation therapy uses a machine outside the body to send radiation toward the cancer.
*Internal radiation therapy uses a radioactive substance through needles, wires, or catheters that are placed directly into or near the site of cancer.
But again, the choice of radiation therapy would depend on the type and grade of tumour being treated. Generally external radiation therapy is used to treat childhood brain tumours.
#Chemotherapy: This is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from multiplying.
*When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body.
*But, when chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs affect cancer cells in the specific areas only.