Long-term neurological outcome of childhood brain tumors treated by surgery only.
OBJECTIVE
To evaluate the pattern of neurological late effects in patients who have received surgery only for a brain tumor in childhood and to identify possible risk factors for neurological sequelae.


METHODS
The medical, histologic, and operative records were reviewed for 65 consecutive patients operated for a benign brain tumor from 1970 to 1997, and all patients were re-examined after a median length of follow-up of 10.7 years. Thirty-four patients had posterior fossa tumors, 22 patients had cerebral hemisphere tumors, and nine patients had midline tumors.


RESULTS
At the time of follow-up, 20 patients (31%) had no neurological deficits, 22 patients (34%) had minor deficits that did not interfere with their daily life activities, and 23 patients (35%) had moderate or severe deficits such as severe ataxia, spastic paresis, seriously reduced vision, or epilepsy with more than two seizures per year. Fourteen of the 31 patients (45%) registered with ataxia preoperatively had recovered fully. Six of seven patients had persistence of a pre- or postoperatively developed hemiparesis. Thirteen of 23 patients had persistence of cranial nerve deficits that developed second to surgery. Fifty-five percent of the 18 patients with seizures at diagnosis were seizure-free at follow-up. At follow-up both ataxia and hemiparesis were significantly more frequent among females (P =.02 and P =.03, respectively).


CONCLUSIONS
In patients who received operation as the only treatment for their brain tumor, there was a good chance of total or partial recovery of preoperative and postoperative neurological deficits, although only one third of the patients will have no long-term neurological deficits.
Sønderkaer
Signe
S
Pediatric Clinic II and the Department of Growth and Reproduction, Juliane Marie Center, H:S Rigshospitalet, Copenhagen, Denmark.
Schmiegelow
Marianne
M
Carstensen
Henrik
H
Nielsen
Lars Bøgeskov
LB
Müller
Jørn
J
Schmiegelow
Kjeld
K
D000293:Adolescent; D001259:Ataxia / Q000209:etiology; D001932:Brain Neoplasms / Q000150:complications* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior; D003389:Cranial Nerve Diseases / Q000209:etiology; D004827:Epilepsy / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D010243:Paralysis / Q000209:etiology; D010291:Paresis / Q000209:etiology; D011183:Postoperative Complications; D012307:Risk Factors; D012737:Sex Factors; D014786:Vision Disorders / Q000209:etiology