MEDICAL INFORMATION
MAPPING BRAIN TUMORS
Common Childhood Brain Tumors and Locations
BRAIN ANATOMY AND FUNCTIONS
Frontal Lobes – controls motor function, higher cognitive functioning (decision making, planning)
Parietal Lobes – Sensory input (opposite side)
Temporal Lobes – hearing, touch, behavior problems, emotion, language
Medullo Oblongata – lowest part of brain stem, a vital area that controls blood pressure, heart rate, and respiration.
Hypothalamus – controls body temperature, hunger and thirst.
Thalamus – monitors sensory stimuli and stores information related to procedural matters.
Cerebellum – the non-thinking part of the brain; 2nd largest portion of the brain; posterior part of cerebrum; coordinates voluntary movement, balance and fine motor control.
Cerebrum – uppermost portion of the brain; includes both hemispheres that are separated by the cerebral fissure; tumors in this region may cause seizures; vision, speech, and personality changes; weakness or paralysis of arms or legs.
LATERAL VIEW OF A BRAIN STEM
BRAIN TUMOR SYMPTOMS
Common Brain Tumor Symptoms
Most brain tumors present with generalized or focal disturbances.
Symptoms vary and are related to tumor type, location and tumor size or degree of invasion.
*symptoms are related to location of tumor.
Decrease of loss of sensation, temperature, pain, visual disturbances
Hearing changes, hallucinations, loss of memory, aggression, impulsiveness
Headaches (often worse in morning)
Loss of appetite
Nausea or vomiting
Change in growth patterns
Numbness or weakness in arms or legs
Lethargy or fatigue
Loss of balance, wide gait, nystagmus, ataxia; gait disturbances/balance issues
Loss of memory or recall, offensive behavior, aphasia, bladder or bowel incontinence
Visual field deficits, focal sensory seizures, hallucinations
Change in vision or eye movement
Altered mental status (inattention or apathy)
Increased intracranial pressure
BRAIN TUMOR ARTICLES OF INFORMATION
BRAIN TUMOR TYPES
Experts detail the types of brain tumors
High-Grade Gliomas
Normal brain is made up of several cell types including neurons, the main functional cell of the brain, and glia, which play a supportive role to the neurons. Glia are further subdivided into different types, each type with a different function, including oligodendrocytes which cover the axons of neurons with sheathes of myelin, and astrocytes …
Diffuse Intrinsic Pontine Glioma: From Diagnosis to Next-Generation Clinical Trials
LINK TO ARTICLE: Stanford Medicine/Monje Labs/Neurology and Neurological Sciences
Infantile Brain Tumors
Brain tumors are the second most common type of malignancy in children less than 2 years of age. Furthermore, brain tumors as a whole are the most common solid tumor of childhood and 12-15% of all childhood brain tumors occur in children less than two. Childhood brain tumors occur in males more frequently than in …
Germ Cell Tumors of the Brain
Jonathan L. Finlay, MB ChB, FRCP (Lond.), FRCPCH, Director, Neuro-oncology Program; Elizabeth and Richard Germain Endowed Professor of Pediatric Cancer, Division of Peduiatric Hematology, Oncology and Blood & Marrow Transplant, Nationwide Children’s Hospital. Professor of Pediatrics and Radiation Oncology, The Ohio State University, Columbus, Ohio, USA The family of tumors known as germ cell tumors …
Ependymomas
Kathy Warren, MD, pediatric oncologist, National Cancer Institute INTRODUCTION: Although ependymomas are the third most common type of brain tumor in children (following astrocytoma and medulloblastoma), they are relatively rare, with approximately 200 cases diagnosed in the US each year in children and adults less than 25 years of age. Ependymomas account for 6-12% of …
Low Grade Gliomas: A Review
Eva Perdahl, MD, PhD, Children’s National-VA and David Wolf, MD, PhD, Johns Hopkins University Brain tumors are the most common solid tumor of childhood. Among brain tumors, low-grade gliomas are the most common type, accounting for almost 50% of all tumor types. There are two major types of cells that make up the brain: neurons …
Brain Stem Gliomas in Childhood
Paul Graham Fisher, M.D., M.H.S. and Michelle Monje, M.D., Ph.D Brain stem tumors are perhaps the most dreaded cancers in pediatric oncology, owing to their historically poor prognosis, yet they remain an area of intense research. Brain stem tumors account for about 10 to 15% of childhood brain tumors. Peak incidence for these tumors occurs …
Diffuse Intrinsic Pontine Glioma: Past Perspectives and Future Directions
Background Primary CNS tumors are the most common pediatric solid cancer, and account for 23% of malignancy in children under 15 years of age, second only to leukemia. The incidence of newly diagnosed brain tumors in the pediatric population is 3.3 cases per 100,000 children, with 3,000 children diagnosed annually. Brain tumors are also the …
Medulloblastoma
Medulloblastoma is the most common primary malignant central nervous system tumor arising in childhood. Survival rates for children with medulloblastomas have nearly doubled and so has the recognition that many survivors are impaired and new forms of treatment are needed. Its understanding and management represents both the progress and challenges involved in the treatment of …
DIAGNOSTICS AND EPIDEMIOLOGY
Expert articles on diagnostics and epidemeliology of CBT
Epidemiology of Pediatric Brain Tumors
Maral Adel Fahmideh, PhD; Michael E. Scheurer, PhD, MPH, Baylor College of Medicine Introduction Primary brain tumors are the most common solid tumors in children and the leading cause of cancer mortality in this population. Pediatric brain tumors (PBTs) are heterogeneous in histopathology, molecular features, and prognosis, and they are classified into two major categories including …
Successful Cancer Treatment Begins with an Accurate Pathology Diagnosis
Barry M. Shmookler, MD The first crucial step in cancer management is to assure that the pathology diagnosis (the biopsy) is correct and accurate. What is the basis for this statement? A pathologist is the only physician who can make the actual diagnosis of cancer. He/she is a medical doctor with a specialty training in the …
MR Imaging of Brain Tumors
Recent Developments Gilbert Vezina, M.D., Director of Neuroradiology – Children’s National Medical Center, Washington D.C. Imaging techniques to diagnose, stage, and follow patients with brain tumors are central to their clinical management. Magnetic resonance imaging (MRI) is the most commonly utilized technique for lesion detection, definition of extent, detection of spread and in evaluation of …
Classification, Grading and Staging of Pediatric Brain and Spinal Cord Tumors
Ideally, when a child is diagnosed with a brain tumor, a multidisciplinary group of providers (neurosurgeons, neuropathologists, neuro-radiologists, neuro-oncologists, etc.) cooperate to determine the optimal treatment. Many factors influence the decision. Central to considerations are the classification, grading, and staging of pediatric brain tumors. With the exception of only a few tumor types and locations, …
LATE EFFECTS
Late effects of brain tumors
Neurotoxicity
Changes in the Brains of Children with Brain Tumors of the Central Nervous System Neurotoxicity is a significant tumor-and treatment-related complication for a number of childhood cancer survivors. It is particularly relevant for children with brain tumors who require therapy specifically directed at the central nervous system. Despite its significance, relatively little is known about …
Cerebellar Mutism
by Loice Swisher, M.D., co-authored by Dr. Peter Philips New resources added at the end of this article. A child s loss of speech after removal of a cerebellar tumor was initially described in 1958 (Daly and Love 1958). Cerebellar mutism was first reported in 1979 by Hirsch after a posterior fossa tumor resection. In …
The Visual System and Childhood Brain Tumor
Michael X. Repka, M.D., Vice Chair for Clinical Practice, Wilmer Eye Institute, Professor of Ophthalmology, Johns Hopkins University School of Medicine, N. Wolfe Street, Baltimore, MD 21287-9028 Childhood brain tumors present with visual symptoms about 50% of the time. Additionally, children will develop visual symptoms and/or signs during and after treatment. Such signs may become …
Survivors of Childhood Brain Tumors: the Potential for Late Effects
Sara Bottomley, RN, MSN, CPNP The survival rate of patients with childhood brain tumors continues to improve. However, survivors are at risk for a variety of physical, medical, cognitive, and/or psychosocial late effects. These late effects may be directly related to the type, location and extent of the brain tumor itself or a result of …
Hypopituitarism in Pediatric Brain Tumor Survivors
Dr. Maya Lodish, pediatric endocrinologist National Institute of Child Health and Human Development National Institutes of Health, Bethesda, MD Survivors of childhood brain tumors are at an especially high risk for damage to the endocrine system. The endocrine system is comprised of glands and hormones that help to control specific functions of the body, such …
Behavior Problems in Children who have Undergone Treatment for Brain Tumors
Mary Ann McCabe, Ph.D., clinical psychologist, Society for Research in Child Development Children and adolescents who have undergone treatment for brain tumors may be more likely to exhibit behavior problems than their peers. There have been relatively few formal studies of this issue, and behavior problems have often not been included in studies of neuropsychological …
TREATMENTS AND THERAPIES
articles on treatments and therapies for CBT
Pediatric Brain Tumor National and International Clinical Trials Consortia: an Overview
As the care of children with brain tumors evolves, there is recognition that despite advances in surgery, chemotherapy and radiation therapy, there are clear needs to explore other options and to create mechanisms where new therapeutic approaches can be assessed carefully and expeditiously. Over the past 2 decades, multiple clinical trials consortia have been developed …
Impact of New Molecular Understandings on Brain Tumor Clinical Trial Design Performance
Dr. Roger J. Packer The Childhood Brain Tumor Foundation was pleased to be a Silver Sponsor for the comprehensive 17th International Symposium on Pediatric Neuro-Oncology. Our Neurotransmitter Fall-Winter edition will cover other topics from the other conference. This summary covers a topic from Family Day and Educational Day, held June 11, 2016, related to molecular …
Proteomics
Over the last decade, there has been an explosion in the amount of data generated from the DNA and RNA sequencing studies. Essentially, these data inform us about the blueprints of the cancer cell – the instructions it uses to carry out its primary function of cellular proliferation. However, translating these findings into new therapies …
Angiogenesis Inhibitors – An “Old Frontier” in Cancer Therapy
by Tobey MacDonald, M.D., Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA In 1971, Dr. Judah Folkman, then surgeon-in-chief of Children’s Hospital Boston, reported in the New England Journal of Medicine that solid tumors are dependent on “angiogenesis”, the formation of new blood vessels, for survival and growth. He proposed that …
The Power of Protons for Pediatric Brain Tumors
Sameer Keole, M.D. Medical Director, ProCure Proton Therapy Center in Oklahoma City When a child is diagnosed with cancer it is devastating for the entire family. The good news is that cure rates for childhood cancer are at nearly 80 percent thanks to ongoing research that has improved the diagnosis and treatment of pediatric cancers. …
Surgery and Radiation Therapy for Craniopharyngioma
Ori Shokek, M.D., Moody D. Wharam, Jr., M.D., F.A.C.R. Craniopharyngioma is a brain tumor that occurs in children. It is seen in the suprasellar region of the brain, a centrally located area adjacent to critical structures including the nerves that conduct visual signal from the eyes to the brain, the ventricular system which governs the …
Angiogenesis Inhibitors: A New Frontier in Cancer Therapy
Tobey J. MacDonald, M.D. For over 50 years, the field of cancer therapy has been dominated by the concept that the tumor must be the selected target of the chemotherapy delivered. Therefore, any drug with the ability to directly kill tumor cells in the laboratory was by definition a candidate for use as chemotherapy in …
Targeting H3.3 Mutations in Pediatric HGG
Brendan Price, Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA. Pediatric high-grade gliomas (pHGG) have few treatment options and most children diagnosed only survive for 1-2 years. Identifying new treatments is therefore of the highest priority. Work in the lab is focused on understanding how these brain tumors arise, with the …
Proton Therapy: A Treatment Option for Children with Brain Tumors
Hillary Bennett and Catherine M. Mannix, RN, BSN, OCN The diagnosis of a brain tumor is never welcome news for anyone. But this type of cancer is especially problematic in children, as their developing nervous systems are particularly sensitive to the effects of radiation, a major form of treatment for brain and other solid pediatric …
Advances in Surgical Technique for Childhood Brain Tumors
Introduction I will divide advances in surgical technique over the past several decades into 4 major categories: greater visual magnification, improved aids to navigation, better functional brain mapping, and more precise tumor destruction. Magnification The operating neurosurgical microscope has been used since the 1950’s when Dr. RMP Donaghy of the University of Vermont was active …
Targeted Radio-Immunotheraphy for Malignant Brainstem Glioma
PI: J. Bryan Iorgulescu, Weill Cornell Medical College, 2011-2012 I have a deep-seated passion for pediatric neuro-oncology research and wish to pursue a career where I can directly fight children’s brain cancers – & hopefully one day, help find a cure. Delving into this project along side my medical school studies at Weill Cornell Medical …
Molecular Profiling of Pediatric Cancer
Eric Raabe MD, PhD One of the goals of pediatric cancer treatment is deploying personalized medicine. Treating each patient and each tumor, with exactly the right type of therapy to maximize killing of tumor cells and minimize side effects to patients is the objective. Initially, brain tumors were classified by their appearance under the microscope. …
Radiosurgery Expands Treatment Options for Children and Infants with Tumors of the Brain and Spine
Nothing is more frightening than to learn that your child has a brain tumor. These serious tumors are unfortunately all too common; in fact, malignant brain tumors are the most frequent type of solid cancer seen in childhood. To make matters more difficult, conventional radiation therapy – a mainstay of treatment for adults – cannot …
Cancer Stem Cells: A New Paradigm
by David M. Panchision, Ph.D., Investigator, Center for Neuroscience Research, Children’s National Medical Center, Washington, DC Central Nervous System (CNS) tumors are one of the most prevalent forms of cancer in the U.S. and are the leading cause of cancer deaths in children (1-3). Current therapies can affect all cells, as with radiation, or highly …
Stereotactic Radiosurgery
Michael R. Kuettel, M.D., Ph.D. Abstract: Stereotactic radiation is a method of delivering focused irradiation to both benign and cancerous lesions. This form of treatment can be administered in single or multiple fractions (radiosurgery or stereotactic radiotherapy, respectively). This technology has evolved rapidly due to advances in both hardware and software design. Clinical indications for …