Document Type : Original research
Author
Neurosurgeon, Department of Surgery, College of Medicine, University of Kirkuk, Kirkuk, IRAQ.
Abstract
Background: Medulloblastoma and cerebellar astrocytoma are common brain tumors in children, often associated with intracranial pressure and cerebellar dysfunction. Early diagnosis and complete surgical resection are crucial for improving patient outcomes. This study aimed to evaluate the clinical presentation, radiological features, surgical outcomes, and postoperative complications in children with these two tumors.
Methods: A prospective study was conducted between 2000 and 2002 at the Surgical Specialties Hospital on 50 children with histopathologically confirmed medulloblastoma and cerebellar astrocytoma. The patients, aged 2 to 19 years, had a peak incidence between 5 and 10 years, with no significant gender differences. CT imaging assessed tumor location and characteristics. Surgical interventions included shunt operations for hydrocephalus and suboccipital craniectomy for tumor resection. Postoperative complications, such as pseudomeningocele and cerebellar mutism, were monitored.
Result: Medulloblastomas showed a typical midline location with hyperdensity and homogeneous enhancement on CT. In cerebellar astrocytomas, 60% were midline and solid. Total tumor removal occurred in 46.7% of medulloblastomas and 50% of cerebellar astrocytomas. Incomplete removal was often due to brain stem involvement, particularly in medulloblastomas. Postoperative complications were more common in medulloblastoma patients, with a mortality rate of 6.7% for medulloblastomas and 10% for cerebellar astrocytomas.
Conclusions: Early diagnosis and complete tumor removal with proper postoperative care are essential to reducing morbidity and mortality in children with these tumors.
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