CLINICOPATHOLOGICAL STUDY AND MANAGEMENT OF PAEDIATRIC POSTERIOR CRANIAL FOSSA TUMOURS
Ranjit Behera, Gayatri Rath*, Sanjib Mishra and Ashok Kumar Panda
ABSTRACT
Introduction: Paediatric brain tumours are one of the leading causes of death among solid tumours of childhood. Posterior fossa tumours are more common in children in first decade of life. Brain stem compression, herniation and death are some of the important complications of these tumours. Most of the patients are critically ill at the time of presentation and need an emergency operative procedure, especially if they present with acute symptoms of brain stem involvement or herniation. Materials and methods: A total number of 52 cases of posterior fossa tumours who attended the neurosurgery department during the period from November 2015 to February 2018 were studied. Detailed clinical profile of the patient including presenting signs and symptoms were recorded. Children with features of raised intra cranial pressure were further investigated to rule out obstructive hydrocephalus. Almost all children were treated surgically followed by adjuvant therapy. Results: Maximum number of cases were found in between 6 to 10 year age group with slight female preponderance. The most common tumour encountered in this study was pilocytic astrocytoma(32.7%) followed by medulloblastoma(25%). CSF diversion procedure was done in most cases (86%). About 90% of patients underwent definitive surgery. Overall recurrence rate was 12.76% and mortality rate was 26.92%. Conclusion: Posterior cranial fossa tumours are more common in children than adults. Hydrocephalus is common, occurring in 71-90% of paediatric patients. Patients older than 3 years have relatively long term survival rates of approximately 85% in comparison to children less than 3 years of age.
Keywords: Brain tumours, Paediatric, posterior fossa.
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