Neurosurgical Management of Cerebral Astrocytomas in Children

Abstract

A study of astrocytomas occurring in children (mean age 9.13 years) is reported. Two hundred sixty-one cases operated within 10 years (1986-1995) were reviewed. The subtentorial localization was preponderant and was seen in 145 cases (55.04%). The pathological results for supratentorial astrocytomas show an important number of high-grade, malignant astrocytomas--74 cases (64.3%). Surgery was the most important aspect of the treatment. The microscopic tumoral removal was total in 201 cases (77%), subtotal in 37 cases (14.2%); bioptic sampling was done in only 23 cases (8.8%). In grade III and IV astrocytomas, radiotherapy (high-voltage) and chemotherapy were routinely used. The patients were followed-up, both clinically and by CT, between 6 months and 10 years. Neurological evaluation (6 months post-operative) shows a preponderance of minimal sequelae (71%). Clinical signs of recurrences occurred in 56 cases (21.45%). In 37 cases (66.07%), a surgical indication was retained. Cumulative probability of survival of children with intracranial astrocytomas at 1 year was 0.714 and at 5 years was 0.655.

Management of Childhood Brain Tumors: Consensus Report by the Pediatric Hematology Oncology (PHO) Chapter of Indian Academy of Pediatrics (IAP)

“…High-Grade Gliomas Frequently between 5 and 10 years of age, Anaplastic astrocytoma and glioblastoma are highgrade Gliomas (HGG) [26]. On CT and MRI, HGG typically appear as irregularly shaped lesions with partial contrast enhancement and peri tumoral edema with or without mass effect [27].…”