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Journal of Child Neurology
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Initial Management of Childhood Brain Tumors: Neurosurgical Considerations

Farideh Nejat, MD, MPH

Department of Neurosurgery, Children's Hospital Medical Center, Medical Sciences/University of Tehran, Tehran, Iran

Mostafa El Khashab, MD, PhD

Department of Neurosurgery, Hackensack University Medical Center, Hackensack, New Jersey

James T. Rutka, MD, PhD, FRCSC, FACS

Division of Neurosurgery, The Hospital for Sick Children, The University of Toronto, Toronto, Canada, james.rutka{at}sickkids.ca

Intracranial tumors are the most common solid tumors in children. The infratentorial compartment will be the primary site for 60% to 70% of these tumors, including astrocytomas, medulloblastomas, and ependymomas. Several technological advancements have increased our knowledge of the cell biology of pediatric brain tumors, facilitated earlier diagnosis, and improved neurosurgical resections while minimizing neurological deficits. These in turn have not only improved the survival of children with brain tumors but also their quality of life. Current management strategies in most cases rely on surgery coupled with adjuvant therapies, including radiation therapy and chemotherapy. The vulnerability of the immature brain to adjuvant therapies creates many challenges for the treating physician. We review current diagnostic and therapeutic approaches and outcome for children harboring the most common pediatric brain tumors: astrocytomas (low-grade and high-grade glioma), ependymoma, medulloblastoma, and craniopharyngioma. The emphasis will be on the neurosurgical management of children with these tumors.

Key Words: craniopharyngioma • ependymoma • glioma • medulloblastoma • pediatric brain tumors • neurosurgery

Journal of Child Neurology, Vol. 23, No. 10, 1136-1148 (2008)
DOI: 10.1177/0883073808321768
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