Cerebellar astrocytomas: a 24-year experience.
BACKGROUND
Cerebellar astrocytomas are the most benign tumors of the CNS. Seventy to eighty percent are found in children.


RESULTS
We report on 38 children under 18 who had cerebellar astrocytoma in the posterior fossa and were treated by a multidisciplinary team in our Neurosurgical Department from January 1974 to December 1997. We included all patients in whom the histopathological diagnosis was astrocytoma, regardless of malignancy. The diagnostic methods used were pneumoventriculography, cranial X-rays, CT scan, and MRI. All patients were treated surgically. Neither radiotherapy nor chemotherapy was indicated in patients with pilocytic or fibrillary astrocytomas. A greater prevalence was observed in female (25/38; 66%) than in male (13/38; 34%) patients. Histopathological results revealed 27 (71%) pilocytic astrocytomas, 8 (21%) diffuse fibrillary astrocytomas, 1 (2%) anaplastic astrocytoma and 2 (6%) glioblastomas. These tumors were more frequently located in the right cerebellar hemisphere; increased intracranial pressure syndrome was the most frequent form of clinical presentation. Total tumor resection was obtained in 29 (83%) cases and subtotal resection in 9 (17%). In 6 (16%) cases, ventriculoperitoneal shunts were placed to control persistent hydrocephalus after tumor excision.


CONCLUSIONS
The most frequent complication was increased ataxia. The mortality rate was 8.5%.
Viano
J C
JC
Servicio de Neurocirugia, Hospital Infantil Municipal, Jujuy 3000, CP 5000, Córdoba, Argentina. pediatría@mensajes.com
Herrera
E J
EJ
Suárez
J C
JC
D000293:Adolescent; D001254:Astrocytoma / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D002531:Cerebellum / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome