The following tests may be used to detect a brain tumor and identify its location:
CT-guided biopsy (may confirm the exact type of tumor)
CT scan of the head
Examination of the cerebral spinal fluid (CSF)
MRI of the head
Early treatment often improves the chance of a good outcome. Treatment depends on the size and type of tumor and the child's general health.
The following are treatments for specific types of tumors:
Astrocytoma -- The main treatment is surgery to remove the tumor.
Brainstem gliomas -- Surgery is usually not possible because of the tumor's location in the brain. Radiation and chemotherapy are used to shrink the tumor and prolong life.
Ependymomas -- Treatment may include surgery, radiation therapy, and chemotherapy.
Medulloblastomas -- Surgery alone does not cure this type of cancer. Chemotherapy and radiation are often used in combination with surgery.
The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child's comfort.
Surgery is needed for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of entirely removed. Debulking is a procedure to reduce the tumor's size without completely removing it.
In cases where the tumor cannot be removed, surgery may help reduce pressure and relieve symptoms.
Radiation therapy and chemotherapy may be used for certain tumors.
Other medications used to treat primary brain tumors in children include:
Corticosteroids such as dexamethasone to reduce brain swelling
Diuretics such as urea or mannitol to reduce brain swelling and pressure
Anticonvulsants such as phenytoin or levetiracetam to reduce or prevent seizures
Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life. Counseling, support groups, and similar measures may be needed to help the family cope with the disorder.
How well the child does depends on many things, including the exact type of tumor. About 3 out of 4 children survive at least 5 years after being diagnosed.
Long-term brain and nervous system problems may result from the tumor itself, or from treatment. Children may have problems with attention and concentration, memory, processing information, planning, insight, initiative or desire to do things, and the ability to stay organized and on-task. Children younger than age 7 (and especially those younger than age 3) appear to have the greatest risk for these problems.
Parents need to make sure that children receive needed support services at home and school.
Brain herniation (often fatal)
Loss of ability to interact or function
Permanent, worsening, severe brain and nervous system (neurological) problems
Side effects related to chemotherapy and radiation
Tumor returns (relapse)
Calling your health care provider
Call a health care provider if a child develops persistent headaches or other symptoms of a brain tumor.
Go to the emergency room if a child has a seizure that is unusual or suddenly develops stupor (reduced alertness), vision changes, or speech changes.
Buckner JC, Brown PD, O'Neill BP, Meyer FB, Wetmore CJ, Uhm JH. Central nervous system tumors. Mayo Clin Proc. 2007;82(10):1271-1286.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Central nervous system cancers. V.2.2009.
Wilne S, Koller K, Collier J, Kennedy C, Grundy R, Walker D. The diagnosis of brain tumours in children: a guideline to assist healthcare professionals in the assessment of children who may have a brain tumour. Arch Dis Child. 2010;95:534-539.
Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.