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Clinical features of children's brain tumors according to location

Korean Journal of Pediatrics 2006;49(1):76-81.
Published online January 15, 2006.
Clinical features of children's brain tumors according to location
Seung Jeong Han, Yun Hee Kim, Young Se Kwon, Yong Hoon Jun, Soon Ki Kim, Byong Kwan Son
Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
소아 뇌종양 발생위치에 따른 임상양상 고찰
한승정, 김윤희, 권영세, 전용훈, 김순기, 손병관
인하대학교 의과대학 소아과학교실
Correspondence: 
Young Se Kwon, Email: ysped@inha.ac.kr
Abstract
Purpose
: This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location.
Methods
: A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI.
Results
: The male to female ratio was 1 : 0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval.
Conclusion
: The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.
Key Words: Brain tumor , Location , Pre-diagnostic symptomatic interval , Parents and doctor's delay


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