title: Long-term outcome in children with low grade tectal tumours and obstructive hydrocephalus.
abstract: BACKGROUND
  Neuropsychological deficits after treatment of paediatric brain tumour are well known, but not the role of hydrocephalus in these deficits.
  
  
  OBJECTIVE
  To study long-term neurological, cognitive, and behavioural deficits in children with a low grade tectal tumour and acquired obstructive hydrocephalus.
  
  
  METHODS
  In a consecutive series of 12 children with low-grade tectal tumour diagnosed in our hospital between 1994 and 2008, neurologic, neuropsychological, and radiologic data were prospectively collected. Intelligence, memory, attention, language, visual-spatial, and executive functions were assessed. Median follow-up was 2 years and 9 months.
  
  
  RESULTS
  At follow-up, most frequent neurologic disability was fatigue in children with a low-grade tectal tumour. They scored lower on sustained attention, long-term memory and had more behavioural problems. Factor influencing cognition was persisting severe hydrocephalus at time of assessment. The cognitive problems resulted in 60% of children needing assistances of special services at school.
  
  
  CONCLUSIONS
  At long-term, children with a low-grade tectal tumour display invalidating neuropsychological impairments resulting in educational problems. Adequate treatment of hydrocephalus may result in better cognitive functioning. Our findings suggest that part of the symptoms of the cerebellar cognitive affective syndrome may not have resulted from a cerebellar lesion itself but rather from a cerebral dysfunction or compression of supratentorial structures in the cerebello-cortical circuitry due to the obstructive hydrocephalus.
authors.affiliation: Department of Paediatric Neurology, Erasmus MC/ Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: f.aarsen@erasmusmc.nl.
authors.forename: Femke K
authors.initials: FK
authors.lastname: Aarsen
authors.affiliation: Department of Paediatric Neurology, Erasmus MC/ Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Willem F M
authors.initials: WF
authors.lastname: Arts
authors.affiliation: Department of Paediatric Neurosurgery, Erasmus MC/ Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Marie L C
authors.initials: ML
authors.lastname: Van Veelen-Vincent
authors.affiliation: Department of Paediatric Radiology, Erasmus MC/ Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Maarten H
authors.initials: MH
authors.lastname: Lequin
authors.affiliation: Department of Paediatric Neurology, Erasmus MC/ Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Coriene E
authors.initials: CE
authors.lastname: Catsman-Berrevoets
mesh_terms: D000293:Adolescent; D001526:Behavioral Symptoms / Q000209:etiology*; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000150:complications*; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D003336:Tectum Mesencephali / Q000473:pathology*; D055815:Young Adult
keywords: Behaviour; Children; Cognition; Hydrocephalus; Tectum; Tumour