Though childhood brain tumor is a rare disease, still, many children of any age all over the world suffer from this condition. Unlike the brain tumors in adults, brain tumors in children is a bit different. Brain tumors are probably the most common form of solid tumors affecting children. However, having knowledge of the symptoms, probable treatment of the disease can help the parents in coping with the situation in a better way and taking the right decision at the right time.

What is a brain tumor?
A group of abnormal cell growth in the brain is referred to as a brain tumor. The types of brain tumor depend upon the structure of the tumor cells, their rate of growth, composition and several other characteristics. However, two most common types of brain tumor affecting children are primary and secondary. In primary brain tumor, the tumor cells develop in the brain, while in secondary, cancerous cells invade the brain from other parts of the body.

Symptoms that determine the presence of tumor may vary in every child. The variation is due to certain aspects including size of the tumor, the location of the tumor, how the tumor is affecting the brain, etc. Some of the most common symptoms of childhood brain tumor are severe headaches, occasional seizures, feeling of sickness and vomiting, eye problems such as blurred visions, feelings of drowsiness without any reason, etc. Some children suffering from brain tumour may also experience difficulty in maintaining balance when walking or behavioral changes in children.

Treatment
While for some, surgical removal of the tumor may be the only treatment solution, for some sessions of radiotherapy and chemotherapy turn out to be really helpful. To control or reduce the effects of the brain tumor symptoms, taking regular medications may also be necessary for the affected children. Doctor may devise the best treatment plan despending on the condition of a child. As the treatment completely depends on the severity of the problem.

Prognosis
Depending on the grade, location, and type of tumor as well as the treatment, the overall health of children can be determined. While a significant number of children often successfully recover from the brain tumor, for some, the treatment needs to be continued for many years. As the nervous system of a child is in its developing stage, sometimes, children may develop some kind of learning or behavioral or physical disability as a result of the brain tumor treatment. If a child has any of these symptoms mentioned above, his or her parents should consult a medical professional right away. The sooner it is diagnosed, the better are the chances for the child to recover from a brain tumor.


Brain Tumor In Children - Understanding It In Detail!

Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.

Prologue:

Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain,that forms a tumor in the brain.Tumours can be either benign or malignant.

Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.

Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.

Symptoms:

There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.

Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:

Headaches.

Seizures.

Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.

Difficulty walking or clumsiness.

Vision changes.

Changes in alertness.

Behavioural impairment.

Causes:

Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.

What are the risk factors for brain cancer?

Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome

Personal history of cancer or family history of brain cancer

Impaired immune system

Radiation therapy of the head

Treatments Options:

Treatment

Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.

Stereotactic radiosurgery

Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors.

Brain Cancer

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

If you have noticed your child to be restless and anxious all the time, it might look cute as the child is highly energetic, but it could be a cause for concern at the same time. It is not normal and the child could be having ADHD that is attention deficit hyperactivity disorder. As the name suggests, it is a disorder with deficiency of attention and in which the child is always hyperactive.

ADHD is a disorder in which the symptoms usually show up before the age of seven. It is characterized by a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness. The impact of these symptoms is felt extensively where his overall self-esteem is affected, be it at home, preschool or school, academics or extracurricular activities and in interpersonal relationships.

The most common symptoms, which are almost diagnostic of ADHD are:

Inability to hold attention: The child's attention span is very short and it is very difficult to keep them engaged on one particular thing.
Increased restlessness: The child would be extremely restless and gets distracted easily.
Fidgeting: The child would be seen constantly fidgeting with his fingers.
The following are the less common ones:

Learning disability is rare, but can happen. However, the good news is that it does not affect the child's intelligence.
Sleep disorders
Difficulty in following directions
Poor executive functioning skills
Disorganization, which can lead to poor motor coordination and impaired movements
ADHD kids tend to forget things very easily and need help with coordinating movements
The child suffering from ADHD could easily tire and/or feel lethargic with very low energy levels. This can lead to the child procrastinating things and not wanting to do things on priority basis
These children also have difficulties with fine motor and cognitive skills and so there is delay in their overall participation in games.
While these are the pressing symptoms of ADHD, occupational therapy can play a significant role in managing the child in the following ways. As a first step, the caregiver should have a detailed discussion with the school staff and any other people with whom the child interacts significantly.

This will help identify areas that need support from an Occupational Therapy, which are the following:

Support with gross and/or fine motor skills
Support with improving handwriting
Support with engaging in playing sports and games
Support in engaging in social activities
Improving sensory processing difficulties
Improving visual perception
Support in adapting to the environment
Teaching strategies to participate in various social and academic activities
So, while an ADHD child is definitely a cause for concern, proper support from family can help manage the condition.

ADHD - Know The Symptoms

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

Abnormal blood vessels
Aneurysm
Bleeding
Blood clots in the brain
When the protective tissue or dura is damaged
Epilepsy
Due to nerve damage
Parkinson's disease
Any kind of pressure after an injury
Abscesses
Skull fractures
In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Risks:
Brain surgeries may be associated with several risks. They may be:

Allergic reactions to anesthesia
Bleeding
Blood clot formations
Swelling of the brain
A state of coma
Impairment in speech, coordination and vision.
Problems in memory
Strokes and seizures
Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease.

Brain Surgery - When It Is Required?

Grading of brain cancer is entirely different as compared to the staging of other cancers in the body. Cancer in the breast, lung, colon etc. are staged depending on the possible spread, location of a tumor and lymph node involvement etc. However, brain tumors are graded based on the aggressiveness of the tumor cells under a microscope. The resect ability and the grade of the tumor cells guide a doctor on the treatment decisions. The decision of a brain surgery depends on factors such as the location, spread of a tumour and the general health of the patient.

Types of Brain Tumor Grading:

Grade 1 tumor- These sets of tumors are medically known as the juvenile pilocytic astrocytoma and subependymoma. They are slow growing and non-invasive. There is a likelihood of the patient getting cured with surgery.
Grade 2 tumor- These are brain tumors that do not possess dead cells as part of the tumour. But, they do portray a lot of abnormal cells. Tumors of this type can be categorized under oligodendroglioma, astrocytoma, and ependymoma.
Grade 3 tumor- Tumors of this type are graded based on the cell type of the cancer cells. For instance, an anaplastic astrocytoma is a grade 3 tumor that has no dead cells but possesses dividing cells. In contrast, anaplastic ependymoma and anaplastic oligodendroglioma are grade 3 tumor cells that have dead cells in them.
Grade 4 tumor- Tumors of this type are referred to as glioblastoma. The tumor cells are actively dividing, the growth of blood vessels is witnessed and areas of dead tissue keep expanding.

Treatment options:
Surgery- If the location of a brain tumor is such that it is accessible to a surgeon, the latter goes ahead and removes most of the tumor if not the whole. If, however, the brain tumor cells are placed very near to the surrounding very sensitive brain tissues, a doctor might remove a small portion of the tumor to curb its growth.
Radiation Therapy- This mode of treatment uses high energy X-ray beams to kill targeted cells of the brain. External beam radiation usually targets a small area of the brain. A whole brain radiation, on the other hand, is usually employed when a tumor has spread to most parts of the brain. Radiotherapy is now so evolved that it is highly targeted to tutor cells that kills cancer and spares normal brain .
Chemotherapy- Chemotherapy employs drugs to kill cancer cells. Chemotherapy can either be taken in the form of an IV or in the form of pills. The dosage of chemotherapy is decided based on the concentration of cancer cells, spread frequency, platelet count of the patient etc. The most common chemotherapy drug that is prescribed by doctors to fight cancer cells is temozolomide.

Brain Tumor - Stages and Treatment!

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