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Long-Term Neurological Outcome of Childhood Brain
Tumors Treated by Surgery Only
Signe Sønderkær, Marianne Schmiegelow, Henrik
Carstensen, Lars Bøgeskov Nielsen, Jørn Müller,
Kjeld Schmiegelow
From the Pediatric Clinic II and the Department of Growth and
Reproduction, Juliane Marie Center, Clinic of Neurosurgery, Neurocenter, The
University Hospital, H:S Rigshospitalet, Copenhagen 2100, Denmark.
Address reprint requests to Kjeld Schmiegelow, PhD, Pediatric Clinic II, Juliane
Marie Center, H:S Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark;
email: kschmiegelow@rh.dk.
Purpose. 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.
Patients and 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).
Conclusion. 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.
Supported by The Ville Heise Foundation (grant M1-96), The
Haensch Foundation, and the Fraenkel Foundation.
© 2003 American Society for Clinical Oncology
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