title: Pediatric brain tumors in Nigeria: clinical profile, management strategies, and outcome.
abstract: BACKGROUND
  Although modern neuroimaging has facilitated early care of brain tumors in children worldwide, there are, however, few published reports on clinical profile, treatment, and outcome of brain tumors in children from our subregion.
  
  
  OBJECTIVE
  We aimed to retrospectively study the clinical profile and outcome of pediatric brain tumors in a tertiary referral center from a developing country.
  
  
  METHODS
  Forty pediatric patients with histologically verified brain tumors managed by the authors over a 13-year period (May 1994-April 2006) were studied. Patients' data from clinical, radiological, and pathology records were analyzed using the statistical package for social sciences version 16.
  
  
  RESULTS
  The mean age was 9.75 years (range 1-15 years). Twenty-two males, 18 females. Common presenting symptoms were headaches (23 patients, 57.5%) and seizures (15 patients, 37.5%). Hyperreflexia (72.5%) and focal motor deficits (62.5%) were the most common neurologic signs. The mean interval from onset of symptoms to neurosurgical diagnosis was 13.4 months (95% CI). All patients had tumor resection, while 11 (27.5%) patients received adjuvant radiotherapy. Hydrocephalus occurred in 19 (47.5%) patients and was associated with early presentation (X2 = 10.65, p < 0.01). Low-grade astrocytoma (25%) and medulloblastoma (25%) were the most common tumors. Survival at 1 and 5 years were 56 and 47%, respectively.
  
  
  CONCLUSIONS
  Focal motor signs and elevated intracranial pressure are the salient presenting features of brain tumors in children seen in Nigeria. Those of them with hydrocephalus are likely to present early. The outcome for pediatric brain tumors remains poor.
authors.affiliation: Department of Neurological Surgery, Institute of Neurosciences, University College Hospital, Ibadan, Oyo State, Nigeria. kechyenny@yahoo.com.|Neurological Surgery Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria. kechyenny@yahoo.com.
authors.forename: E O
authors.initials: EO
authors.lastname: Uche
authors.affiliation: Department of Neurological Surgery, Institute of Neurosciences, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: M T
authors.initials: MT
authors.lastname: Shokunbi
authors.affiliation: Department of Neurological Surgery, Institute of Neurosciences, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: A O
authors.initials: AO
authors.lastname: Malomo
authors.affiliation: Department of Pathology, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: E E U
authors.initials: EE
authors.lastname: Akang
authors.affiliation: Department of Pediatrics, University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: I
authors.initials: I
authors.lastname: Lagunju
authors.affiliation: Department of Anesthesia, University College Hospital, Ibadan, Nigeria.
authors.forename: S D
authors.initials: SD
authors.lastname: Amanor-Boadu
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002528:Cerebellar Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D019635:Neurosurgical Procedures; D009549:Nigeria; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012021:Reflex, Abnormal; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D015996:Survival Rate; D062606:Tertiary Care Centers
keywords: Brain tumor; Clinical profile; Histology; Neuroimaging; Outcome; Pediatric