Central nervous system tumor (peds)

Background

• 2nd most common pediatric cancer (20%)

Diagnosis

• Depends on location
  • Posterior Fossa
    • Headache
      • Early morning (sleep > hypoventilation > hypercarbia > incr CNS bloodflow > incr ICP)
    • Effortless vomiting
    • CN palsies (esp 6th nerve)
  • Brainstem
    • CN deficits (facial weakness, abducens palsy, dysphagia), ataxia
  • Supratentorial
    • HA, personality change, motor weakness, Sz
  • Sellar
    • Visual changes, hypothalamic dysfunction (DI, stunted growth, hypothyroidism)

Work-Up

Head CT

Treatment

• Increased ICP
  • Phenytoin if actively seizing
  • Dexamethsone 1mg/yr of age (max 10mg)
    • Do NOT give if CNS lymphoma is in the ddx

Source

Tintinalli