Symptoms of pediatric brain or spinal cord tumors
All brain tumors are not alike. They are classified by the area from which they grow in the brain or spinal cord and the amount of growth that has occurred when they are diagnosed. The location of the tumor in the brain or spinal cord will also determine the type of symptoms that may occur.
The symptoms of brain tumors in a child often mimic those of common childhood illnesses. Because the symptoms are similar, a brain tumor is not always diagnosed when the symptoms first occur. If the symptoms persist, a parent may become increasingly concerned and ask for additional tests to determine the cause. Sometimes a child's doctor or teacher may notice physical changes in the child that are unusual.
Tumor types covered here are medulloblastoma/PNET, glioma, juvenile pilocytic astrocytoma (JPA), astrocytoma, and ependymoma.
Medulloblastoma/primitive neuroectodermal tumors (PNET)
(Embryonal Tumors)
A medulloblastoma/PNET places a lot of pressure on the inside of the brain and sometimes blocks the flow of cerebrospinal fluid (CSF). Children who have a medulloblastoma may develop hydrocephalus, or "water on the brain," which is actually an abnormal increased amount of CSF within the ventricles. In babies and very young children whose skull bones are not firmly set, hydrocephalus can actually cause the skull to increase in size.
The cerebellum, where a medulloblastoma usually originates, aids in coordinating voluntary movements and maintains balance and muscular tone. The medulla contains the origins of nerves that function in movement of the throat, neck, tongue and swallowing, as well as important functions such as breathing. Children with medulloblastoma/PNET tumors often suffer from headaches, double vision, vomiting, irritability or sleep difficulties. Tasks like handwriting may become difficult. A child may have trouble maintaining balance and may seem unusually clumsy. If the tumor has spread to the spinal cord, the child may experience back pain or trouble walking, bladder and bowel control may become a problem.
Click here to order a copy of Basic Facts about Medulloblastoma/PNET.
Glioma
Historically, the term glioma has been used as a broad, generic name for a large group of tumors that have many characteristics in common yet contain different cell types and behave in different ways. The astrocytoma is a type of glioma. Oliogodendroglioma and ependymoma are gliomas that are referred to as mixed gliomas.
Gliomas can occur anywhere in the central nervous system (CNS). The name given to a glioma is often based on its location. For example, a glioma found along the optic nerves is called an optic nerve glioma. A brain stem glioma is located in the lowest, stem-like portion of the brain.
Symptoms depend on the exact location of the tumor. For example, the cerebellum aids in coordinating voluntary movements and maintaining balance and muscular tone. These are the functions that would be affected by a tumor in that area. A glioma in the cerebrum is likely to cause headaches, nausea, vomiting, weakness of arms or legs, visual disorders, seizures, or intellectual and behavioral problems.
Other symptoms of a glioma may include paralysis of a single part of the body or one side of the body, tremors, hormonal abnormalities or diabetes insipidus. The tumor may cause hydrocephalus or "water on the brain," creating pressure that can cause headaches, nausea, vomiting or visual disturbances. In babies and very young children whose skull bones are not firmly set, hydrocephalus can actually cause the skull to increase in size.
Click here to order a copy of Basic Facts about Gliomas.
Juvenile pilocytic astrocytoma (JPA)
JPAs can arise from the cerebellum, cerebrum or spinal cord. They have also been found in the structures of the eye, hypothalamus, thalamus, and the region of the third ventricle. Although JPAs are typically non-cancerous, that doesn't mean they are harmless. Even a benign tumor can be life-threatening if it is difficult or impossible to reach safely.
Symptoms depend on the exact location of the tumor. The cerebellum, where JPAs often start, aids in coordinating voluntary movements and maintains balance and muscular tone. These are the functions most affected by a tumor in that area. A JPA in the cerebrum is likely to cause headaches, nausea, vomiting, weakness of arms or legs, visual disorders, or seizures. If the hypothalamus or pituitary gland is involved, effects may include early onset of puberty, delayed adolescence, short stature with a decreasing rate of growth, or behavioral changes.
Other indications that a JPA may be present include diabetes insipidus and abnormal thinness. If the main bulk of the tumor is in the cavity of the third ventricle, the flow of cerebrospinal fluid (CSF), may be blocked, causing hydrocephalus or "water on the brain." In babies and very young children whose skull bones are not firmly set, hydrocephalus can actually cause the skull to increase in size.
Click here to order a copy of Basic Facts about Juvenile Pilocytic Astrocytoma (JPA).
Astrocytoma
In children, common locations of astrocytomas include the brain stem, cerebrum and cerebellum. Astrocytomas also arise deep within the brain in the basal ganglia, thalamus, hypothalamus and third ventricle.
Names of specific types of astrocytomas are based on location and other characteristics. For example, cerebellar astrocytomas occur in the cerebellum. There are two types of cerebellar astrocytomas:
- Pilocytic cerebellar astrocytomas, also diffuse or fibrillary cerebellar astrocytomas, are more likely to develop into an anaplastic (malignant) form, spreading into surrounding areas of the brain.
- Astrocytomas that do not fit into another established category are grouped together and called astrocytoma, NOS (not otherwise specified).
The cerebellum aids in coordinating voluntary movements and maintaining balance and muscular tone, so these are the functions most affected by a tumor in that area. Increased intracranial pressure is the main symptom, but other symptoms can occur, depending on the exact location of the tumor.
An astrocytoma in the cerebrum is likely to cause visual disorders or seizures. Other symptoms may include paralysis of a single part of the body or one side of the body, tremors, hormonal abnormalities, or diabetes insipidus. Hydrocephalus, an abnormal accumulation of cerebrospinal fluid (CSF) within the brain, may occur. In babies and very young children whose skull bones are not firmly set, hydrocephalus can actually cause the skull to increase in size.
Click here to order a copy of Basic Facts about Astrocytomas.
Ependymoma
Ependymomas are considered a type of glioma. Types include ependymoma, anaplastic ependymoma, sub-ependymoma and myxopapillary ependymoma. In the brain the most common location for ependymomas is the posterior fossa and the floor of the fourth ventricle. Tumors arising in the posterior fossa often infiltrate the brain stem.
Many symptoms associated with ependymomas are caused by increased intracranial pressure. They may vary depending on the age of the child and exact location of the tumor. In children younger than 2, symptoms may include vomiting, irritability, lethargy, gait disturbance, feeding problems, involuntary eye movement, and increased head size due to hydrocephalus (increased cerebrospinal fluid inside the brain). In children older than 2, vomiting, headache and gait disturbance are the most common symptoms.
Click here to order a copy of Basic Facts about Ependymomas.
The National Cancer Institute (NCI) has an in-depth explanation of pediatric brain and spinal cord tumors. Tumor types not covered here can be found on the NCI website.
