Central nervous system tumor (peds): Difference between revisions
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***[[Cranial nerve palsies]] (especially 6th nerve) | ***[[Cranial nerve palsies]] (especially 6th nerve) | ||
**Brainstem | **Brainstem | ||
*** | ***[[Cranial nerve palsies]] (facial weakness, abducens palsy, dysphagia), ataxia | ||
**Supratentorial | **Supratentorial | ||
***Headache, personality change, motor [[weakness]], [[seizure]] | ***[[Headache]], personality change, motor [[weakness]], [[seizure]] | ||
**Sellar | **Sellar | ||
***Visual changes, hypothalamic dysfunction ( | ***[[Visual disturbances|Visual changes]], hypothalamic dysfunction ([[diabetes insipidus]], stunted growth, [[hypothyroidism]]) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Management== | ==Management== | ||
*[[Increased ICP]] | *[[Increased ICP]] | ||
**Phenytoin, benzodiazepines if actively seizing | **[[Phenytoin]], [[benzodiazepines]] if actively seizing | ||
**[[Dexamethasone]] 1mg/yr of age (max 10mg) | **[[Dexamethasone]] 1mg/yr of age (max 10mg) | ||
***Do NOT give if CNS lymphoma is in the differential | ***Do NOT give if CNS lymphoma is in the differential | ||
Revision as of 18:37, 14 September 2019
For adult patients, see also brain tumor
Background
- 2nd most common pediatric cancer (20%)
Clinical Features
- Depends on location
- Posterior Fossa
- Headache
- Early morning (sleep > hypoventilation > hypercarbia > incrreases CNS bloodflow > inreaced ICP)
- Effortless vomiting
- Cranial nerve palsies (especially 6th nerve)
- Headache
- Brainstem
- Cranial nerve palsies (facial weakness, abducens palsy, dysphagia), ataxia
- Supratentorial
- Sellar
- Visual changes, hypothalamic dysfunction (diabetes insipidus, stunted growth, hypothyroidism)
- Posterior Fossa
Differential Diagnosis
Pediatric Headache
- Primary headache
- Secondary headache
Evaluation
Management
- Increased ICP
- Phenytoin, benzodiazepines if actively seizing
- Dexamethasone 1mg/yr of age (max 10mg)
- Do NOT give if CNS lymphoma is in the differential