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CNS tumors in children - Coggle Diagram
CNS tumors in children
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classification
WHO classification 2016
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embryonal tumors
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PNET=CNS embryonal tumors, not otherwise specified (NOS)
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germ cell tumors
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2/3 pineal, suprasellar, 1/3 supratentorial
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epidemiology
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children: primary CNS tumors, 1/3-1/2 in the posteror fossa
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second most common childhood malignancy, most common solid tumor
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clinical manifestations
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age
young children: irritabity, behavioral changes
any age: nausea, vomiting
older children, adolescents: headache, abnormal gait, poor cordination, papilledema, seizures
infants: macrocephaly, irritability, developmental delay, behavioral changes
congenital: macrocephaly, tense fontanel at birth, polihydramnios
tumor location
posterior fossa: nausea, vomiting, headache, abnormal gait and coordination
brainstem: abnormal gait and coordination, cranial nerve palsies
spinal cord: back pain, weakness, abnormal gait
supratentorial and central: nonspecific syndromes, headache, seizures
chiasmatic/hypothalamic: endocrinopathies - growth impairment, diabetes insipidus, precocious puberty, obesity
diencephalic syndrome: failure to thrive with severe emaciation, normal linear growth, increased appetite, hyperactivity
spinal:peripheral or back pain, focal weakness, gait abnormalities, spinal deformity, torticollis
diagnosis
emergency: head CT, other: cranial MRI, spinal MRI - for staging
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management
seizures:phenytoin, levetiracetam, valproic acid, lamotrigin, topiramate, gabapentin, pregabalin - drug interacions!