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Paediatric Brain Tumour Challenges

This informative session highlights the complexities faced by pediatric brain tumor patients and their families. It covers the spectrum of brain tumors, varying patient engagement, and parental involvement. The talk discusses the symptoms and behaviors of tumors in different locations, emphasizing the range from benign to aggressive types. Treatment options including surgery, chemotherapy, and radiotherapy are explored. Attendees will gain valuable insights for managing these challenges and making informed choices in their child's care journey.

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Paediatric Brain Tumour Challenges

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  1. Paediatric Brain Tumour Challenges Owen Sparrow Patient & Carer Information Day: Brainstrust (Meg Jones) & Samantha Dickson Trust Nov 2010

  2. Patient spectrum • Age range < 16/19/25? • Varying patient engagement • Varying parental involvement • Expectations • Desperate measures • Patient best interest

  3. Where do they occur? • Anywhere in the head… • In the eye socket • Skull base • Throughout the spinal cord (canal?)

  4. How common are they? • 400 per annum in UK (nearly 60 m) • 20 per annum in Southampton • Catchment population 3 m

  5. How do they behave? • Completely indolent to aggressive cancers • Range • Confined, benign & surgically curable • Infiltrative, but indolent • Malignant, but local disease, so curable • Malignant, spreading in CSF (round brain & spinal cord) • Malignant, spreading outside of nervous system • Bleeding • Deformity

  6. What are the symptoms? • Determined by the site: • Visual • Motor • Gait • Co-ordination • Posture • Sensory • Numbness • Tingling or similar

  7. What are the symptoms? • Unrelated to the site: • Pressure • Due to mass • Due to hydrocephalus • Epilepsy • Haemorrhage

  8. What are the treatment options? • Diagnosis • Surgery • Chemotherapy • Radiation • Surveillance

  9. What to choose? • Observation/symptomatic • Curative • Surgical excision • Radiotherapy • Chemotherapy • Palliative • Life-enhancing • Life-prolonging

  10. Tumour examples Initially unsuspected…

  11. Antenatal Hydrocephalus • Routine USS • Worsening hydrocephalus • Options • Await delivery • Induce labour to treat • Treat in utero?

  12. Antenatal MR

  13. Post-natal Ultrasound

  14. 6 Weeks Later

  15. Tumour examples Benign tumour Difficult site…

  16. Lateral ventricular lesion 1 • 15 Year old boy • 3 weeks of headache • Vomited twice • Visual obscurations • Papilloedema • Minimal gait ataxia

  17. Lateral ventricular lesion 1

  18. Lateral ventricular lesion – post-op

  19. Lateral ventricular lesion – post-op

  20. Lateral ventricular lesion 2 • 12 Year old girl • 2 days diplopia • Papilloedema

  21. Lateral ventricular lesion 2

  22. Lateral ventricular lesion 2

  23. Lateral ventricular lesion – post-op

  24. Lateral ventricular lesion – post-op

  25. Lateral ventricular lesion – post-op

  26. It’s not always so simple…

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