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Clinical Presentation and Neurologic Evaluation in Posterior Fossa Tumors in Children

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Posterior Fossa Tumors in Children

Abstract

The major neural structures of the posterior fossa are the brainstem, cranial nerves, and the cerebellum. The signs we see in children mostly with posterior fossa tumors are ataxia, hypotonia, abnormalities in rapid alternating movements, intentional tremor, decreased deep tendon reflexes, and torticollis. The most common eye abnormalities are abducens nerve palsy and nystagmus. The symptoms that children present with posterior fossa tumors are headache, nausea, vomiting, lethargy, strabismus, and macrocephaly due to hydrocephalus and seizures. There are slight variations in the clinical presentation of different tumors. The duration of symptoms before diagnosis, the type of ataxia, and signs due to extension of tumor may differ according to the type. Careful neurologic examination is an important tool in the diagnosis of posterior fossa tumors in children.

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References

  1. Gilman S (1994) Cerebellar control of movement. Ann Neurol 35:3

    Article  CAS  PubMed  Google Scholar 

  2. Localization of lesions affecting the ocular motor system (1996) In: Brazis PW, Masdeu JC, Biller J (eds) Localization in clinical neurology, 3rd edn. Little, Brown and Company (Inc), Boston, pp 155–250

    Google Scholar 

  3. Gilman S (1992) Cerebellum and motor dysfunction. In: Asbury AK, McKhann GM, McDonald WI (eds) Diseases of the nervous system. Clinical neurobiology, 2nd edn. Saunders, Philadelphia, pp 319–341

    Google Scholar 

  4. Posterior fossa syndromes (1973) In: Needham CW (ed) Neurosurgical syndromes of the brain. Charles C Thomas, Springfield, pp 276–346

    Google Scholar 

  5. The extrapyramidal system and the cerebellum (1995) In: Patten J (ed) Neurological differential diagnosis, 2nd edn. Springer, London\New York, pp 178–212

    Google Scholar 

  6. Akil H, Statham PFX, Gotz M, Bramley P, Whittle IR (2006) Adult cerebellar mutism and cognitive-affective syndrome caused by cystic hemangioblastoma. Acta Neurochir (Wien) 148:597–598

    Article  CAS  Google Scholar 

  7. Cerebellar mutism after spontaneous intratumoral bleeding involving the upper cerebellar vermis: a contribution to the pathophysiologic interpretation (2009) Childs Nerv Syst 25:7–11

    Google Scholar 

  8. De-Respinis PA et al (1993) Duane’s retraction syndrome. Surv Ophthalmol 38:257

    Article  CAS  Google Scholar 

  9. Miller NR (1985) Walsh and Hoyt’s neuro-ophthalmology. Williams and Wilkins, Baltimore, p 698

    Google Scholar 

  10. Abducens nerve (2010) In: Binder DK, Sonne DC, Fischbein NJ (eds) Cranial nerves, anatomy, pathology, imaging. Thieme Medical Publishers, Inc., New York, pp 69–81

    Google Scholar 

  11. Elston JS (1992) Organization and control of eye movements. In: Crockard A, Hayward R, Hoff JT (eds) Neurosurgery, the scientific basis of clinical practice. Blackwell Scientific Publications, Boston, pp 224–235

    Google Scholar 

  12. Conjugate eye movements and nystagmus (1996) In: Patten J (ed) Neurological differential diagnosis, 2nd edn. Springer, London, pp 91–103

    Google Scholar 

  13. Gilman N, Baloh RW, Tomiyasu O (1977) Primary position upbeat nystagmus. Neurology 27:294–297

    Article  CAS  PubMed  Google Scholar 

  14. Bender MB (1980) Brain control of conjugate horizontal and vertical eye movements: a survey of the structural correlates. Brain 103:23–69

    Article  CAS  PubMed  Google Scholar 

  15. Brainstem and cranial nerves (1998) In: Duus P (ed) Topical diagnosis in neurology-anatomy, physiology, signs and symptoms. Thieme Medical Publishers, Inc., New York, pp 70–163

    Google Scholar 

  16. Ash PR, Keltner JL (1979) Neuro-ophthalmologic signs in pontine lesions. Medicine 58(4):304–320

    Article  CAS  PubMed  Google Scholar 

  17. Barnett HJ, Hyland HH (1952) Tumors involving the brainstem. Q J Med 21:265

    CAS  PubMed  Google Scholar 

  18. Kameda-Smith MM, White MAJ, St. George EJ, Brown JIM (2013) Time to diagnosis of paediatric posterior fossa tumors: an 11-year West of Scotland experience 200–2011. Br J Neurosurg 27(3):364–369

    Article  CAS  PubMed  Google Scholar 

  19. Dörner I, Fritsch MI, Stark AM, Mehdorn HM (2007) Posterior fossa tumors in children: how long does it take to establish the diagnosis. Childs Nerv Syst 23:887–890

    Article  PubMed  Google Scholar 

  20. Isaacs H Jr (2002) I. Perinatal brain tumors: a review of 250 cases. Pediatr Neurol 27:249–261

    Article  PubMed  Google Scholar 

  21. Di Rocco C, Ceddia Alannelli A (1993) Intracranial tumors in the first year of life: a report of 51 cases. Acta Neurochir (Wien) 123:14–24

    Article  Google Scholar 

  22. Mazewski CM, Hudgins RJ, Reisner A et al (1999) Neonatal brain tumors: a review. Semin Perinatol 23:286–298

    Article  CAS  PubMed  Google Scholar 

  23. Boop S, Wheless J, Van Poppel K, McGregor A, Boop FA (2013) Cerebellar seizures. J Neurosurg Pediatr 12(3):288–292

    Article  PubMed  Google Scholar 

  24. Chae JH, Kim SK, Wang KC, Kim KJ, Hwang YS, Cho BK (2001) Hemifacial seizure of cerebellar ganglioglioma origin: seizure control by tumor resection. Epilepsia 42(9):1204–1207

    Article  CAS  PubMed  Google Scholar 

  25. Chutorian AM, Masters RE, Heier LA. Neurology of the fourth ventricle (1996) In: Cohen AR (ed) Surgical disorders of the fourth ventricle. Blackwell Science, Inc, Cambridge, MA, pp 52–93

    Google Scholar 

  26. Whelan HT, Krower HG, Schmidt MH et al (1998) Current therapy and perspectives in the treatment of medulloblastoma. Pediatr Neurol 18:103–115

    Article  CAS  PubMed  Google Scholar 

  27. Modha A, Vassilyadi M, George A et al (2000) Medulloblastoma in children-the Ottawa experience. Childs Nerv Syst 16:341–350

    Article  CAS  PubMed  Google Scholar 

  28. Crawford JR, MacDonald TJ, Packer RJ (2007) Medulloblastoma in childhood: new biological advances. Lancet Neurol 6:1073–1085

    Article  CAS  PubMed  Google Scholar 

  29. Jenkin O (1996) The radiation treatment of medulloblastoma. J Neurooncol 29:45–54

    Article  CAS  PubMed  Google Scholar 

  30. Raimondi AJ, Tomita T (1982) Hydrocephalus and infratentorial tumors: incidence, clinical picture and treatment. J Neurosurg 55:174–182

    Article  Google Scholar 

  31. Packer RJ, Cogen P, Vezina G, Rorke LB (1999) Medulloblastoma: clinical and biologic aspects. Neuro Oncol 1:232–250

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Duffner PK (2008) Diagnosis of brain tumors in children. Expert Rev Neurother 23:179–183

    Google Scholar 

  33. Maher CO, Raffel C (2004) Neurosurgical treatment of brain tumors in children. Pediatr Clin North Am 51:327–357

    Article  PubMed  Google Scholar 

  34. Mapstone TB (1995) Brain tumors in children. In: Tomsak RL (ed) Pediatric neuroophthalmology. Butterworth-Heinemann, Boston, pp 77–114

    Google Scholar 

  35. Rutka JT, Hoffman HJ, Duncan JA (1996) Astrocytoma of the posterior fossa. In: Cohen AR (ed) Surgical disorders of the fourth ventricle. Blackwell Science, Inc, Boston, pp 189–208

    Google Scholar 

  36. Hoffman HJ, Berger MS, Becker LE (1990) Cerebellar astrocytomas. In: Deutsch M (ed) Management of childhood brain tumors. Kluwer Academic Publishers, Boston, pp 441–456

    Chapter  Google Scholar 

  37. Sanford RA, Gajjar A (1997) Ependymomas. Clin Neurosurg 44:559–570

    CAS  PubMed  Google Scholar 

  38. Lyons MK, Kelly PJ (1991) Posterior fossa ependymomas: report of 30 cases and review of the literature. Neurosurgery 28:659–665

    Article  CAS  PubMed  Google Scholar 

  39. Sutton LN, Goldwein J (2004) Intracranial ependymomas. In: Winn HR (ed) Youmans neurological surgery, 5th edn. WB Saunders, New York, pp 3623–3637

    Google Scholar 

  40. Hargrave D, Bartels U, Bouffet E (2006) Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 7(3):241–248

    Article  PubMed  Google Scholar 

  41. Sandri A, Sardi N, Genitori L et al (2006) Diffuse and focal brainstem tumors in childhood: prognostic factors and surgical outcome. Experience in a single institution. Childs Nerv Syst 22(9):1127–1135

    Article  CAS  PubMed  Google Scholar 

  42. Finlay JL, Zacharoulis S (2005) The treatment of high grade gliomas and diffuse intrinsic pontine tumors of childhood and adolescence: a historical and futuristic perspective. J Neurooncol 75(3):253–266

    Article  CAS  PubMed  Google Scholar 

  43. Ueoka DI, Nogueira J, Campos JC, Filho PM, Ferman S, Lima MA (2009) Brainstem gliomas-retrospective analysis of 86 patients. J Neurol Sci 281:20–23

    Article  PubMed  Google Scholar 

  44. The brain stem (1996) In: Patten J (ed) Neurological differential diagnosis, 2nd edn. Springer, London, pp 162–177

    Google Scholar 

  45. Cerebellum (1998) In: Duus P (ed) Topical diagnosis in neurology-anatomy, physiology, signs and symptoms. Thieme Medical Publishers, Inc., New York, pp 164–179

    Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Neurology, Department of Pediatrics, Acibadem University, Kozyatağı Acıbadem Hastanesi İnönü Cad. Okur sok. No:20, İstanbul, Turkey

    Ugur Işık M.D.

  2. Division of Pediatric Neurosurgery, Department of Neurosurgery, Acibadem University, School of Medicine, Kozyatağı Acıbadem Hastanesi İnönü Cad. Okur sok. No:20, İstanbul, Turkey

    M. Memet Özek M.D.

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  1. Ugur Işık M.D.
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Correspondence to Ugur Işık M.D. .

Editor information

Editors and Affiliations

  1. Neurosurgery, Acıbadem University, Istanbul, Istanbul, Turkey

    M. Memet Özek

  2. Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Napoli, Italy

    Giuseppe Cinalli

  3. Dept. Neurosurgery, Royal Childrens Hospital, Melbourne, Victoria, Australia

    Wirginia Maixner

  4. Pediatric Neurosurgery, Hopital Necker-Enfants Malades, Paris, Paris, France

    Christian Sainte-Rose

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Işık, U., Özek, M.M. (2015). Clinical Presentation and Neurologic Evaluation in Posterior Fossa Tumors in Children. In: Özek, M., Cinalli, G., Maixner, W., Sainte-Rose, C. (eds) Posterior Fossa Tumors in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-11274-9_5

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  • DOI: https://doi.org/10.1007/978-3-319-11274-9_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-11273-2

  • Online ISBN: 978-3-319-11274-9

  • eBook Packages: MedicineMedicine (R0)

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