Pediatric Brain Tumors

[Estimated prevalence of cerebral neoplasm of childhood from the capture-recapture method]

The aim of the study was to estimate the prevalence and fatality rate of primary cerebral neoplasms among children between 1 and 15 years old, State of Bahia, Brazil, 1995. It was a cross-sectional study which includes all cases of brain tumors diagnosed by several sources. From these cases the capture-recapture method was used to estimate the probable number of cases and measure the prevalence and confidence intervals at 95%. By this method it was estimated the existence of 87 cases (CI = 64; 111) of brain tumors in the State, being 72 (CI = 54; 91) in the capital. The estimated prevalence was 1.85/100,000 for children between 1 to 15 years old (CI = 1.36; 2.36/100,000) for the State, and 10.1/100,000 (CI = 7.58; 12.77/100,000) for the capital. The fatality rate was 5.4 percent (CI = 4%; 8%), and 8.9% (CI = 7%; 13%) for the capital and the State respectively. The capture-recapture method showed high precision to estimate the total number of cases. Possible causes of no diagnostic nor treatment of cerebral neoplasms are discussed.

[Clinical epidemiological aspects of cerebral neoplasms in childhood in the State of Bahia, Brazil]

The aim of this study is to describe the relevant aspects of the medical treatment and epidemiology of brain tumors in children between 1 and 15 years old in the State of Bahia, Brazil, first semester of 1995. A cross-sectional design was used for the survey of all new cases and preexisting cases of brain tumors diagnosed through neuroimage among all the children who completed these examinations. Forty eight out of 2,128 were diagnosed as brain tumors, 19 of which being incident cases. In the clinical epidemiological study, the prevalence was 2.3 percent, and the incidence was 0.9 percent. In the prevalent cases, males predominated (1.4:1), and the average age of 10-15 years old (65%). Among the 1-4 years old group predominated incident cases. The astrocytoma was the most frequent brain tumor (41%), and the supratentorial localization predominated by 52%. The ataxia and/or paralysis of cranial nerve and the endocrine and/or visual disturbance symptomatic groups were the most prevalent (82% and 43%, respectively). We discuss the supratentorial localization and the adolescent group predomination in cerebral neoplasms in childhood.

Posterior fossa tumors in children: a case study

Brain tumors are the second most common malignancy to occur during childhood and the posterior fossa is the most common region of the brain affected. Diagnosis and treatment are complex and challenging. Once a child suffering from a posterior fossa tumor is identified, a multidisciplinary team must be assembled to provide comprehensive care through all phases of treatment. The nursing staff is vital to this team because they are often the individuals who coordinate services involved in the care of the child with a posterior fossa tumor. This case study illustrates the phases of diagnosis and treatment of a child with a medulloblastoma and highlights critical care nursing challenges. Following the case study presentation, a summary describes posterior fossa tumors including epidemiology, pathophysiology, clinical manifestations, and outcome. The case study is integrated throughout this review to highlight key issues for critical care nurses to explore.

Critical care of the pediatric oncology patient

The survival rate of children with neoplastic disease has increased significantly because of advances in the diagnosis and treatment of malignancy. The consequences of these scientific advances have led to increased malignancy-related critical complications requiring the expertise of intensive care practitioners. In this article, the authors review common complication associated with malignancies that require admission to the pediatric intensive care unit. Disorders are grouped according to the pathophysiologic mechanism: mechanical effects, systemic effects, related to brain tumors, and complications of intensive chemotherapy or chemo-radiotherapy regimens. Superior vena cava syndrome and brain tumors are described in detail. In conclusion, there is a discussion of outcome data for children with neoplastic disease who are admitted to the pediatric intensive care unit and the role of the advanced practice nurse in influencing patient and family perceptions of the experience.