BACKGROUND: Low grade astrocytomas are among the most common central nervous system tumours in children. AIMS: To identify risk factors for the development of persistent intellectual handicap. METHODS: The notes of 30 children with histologically proven low grade astrocytoma who presented during the period 1987-96 were reviewed. Thirteen of these children who were diagnosed with intracranial tumours between 1992 and 1996 underwent cognitive assessment one year after the completion of treatment. RESULTS: Low grade astrocytomas were found in the cerebellum (59%), thalamus (17%), cerebral hemispheres (10%), and the cervical spinal cord (9%). Where possible all patients were treated with gross total resection of the tumour. Symptomatic children with tumours judged to be inoperable underwent biopsy followed by radiotherapy (13%). Three patients developed progressive disease following surgery and underwent repeat surgery and radiotherapy. Survival at a median follow up of 75 months (range 30-131) is 97%. At one year after the completion of treatment persisting cognitive impairment was common. The strongest predictor of IQ scores was the duration of symptoms of increased intracranial pressure preoperatively. CONCLUSIONS: Although the overall survival rate of children with low grade astrocytoma is excellent, significant long term disability occurs. Early diagnosis is essential to reduce postoperative cognitive morbidity.
BACKGROUND: Low grade astrocytomas are among the most common central nervous system tumours in children. AIMS: To identify risk factors for the development of persistent intellectual handicap. METHODS: The notes of 30 children with histologically proven low grade astrocytoma who presented during the period 1987-96 were reviewed. Thirteen of these children who were diagnosed with intracranial tumours between 1992 and 1996 underwent cognitive assessment one year after the completion of treatment. RESULTS: Low grade astrocytomas were found in the cerebellum (59%), thalamus (17%), cerebral hemispheres (10%), and the cervical spinal cord (9%). Where possible all patients were treated with gross total resection of the tumour. Symptomatic children with tumours judged to be inoperable underwent biopsy followed by radiotherapy (13%). Three patients developed progressive disease following surgery and underwent repeat surgery and radiotherapy. Survival at a median follow up of 75 months (range 30-131) is 97%. At one year after the completion of treatment persisting cognitive impairment was common. The strongest predictor of IQ scores was the duration of symptoms of increased intracranial pressure preoperatively. CONCLUSIONS: Although the overall survival rate of children with low grade astrocytoma is excellent, significant long term disability occurs. Early diagnosis is essential to reduce postoperative cognitive morbidity.
Authors: Gregory T Armstrong; Heather M Conklin; Sujuan Huang; Deokumar Srivastava; Robert Sanford; David W Ellison; Thomas E Merchant; Melissa M Hudson; Mary Ellen Hoehn; Leslie L Robison; Amar Gajjar; E Brannon Morris Journal: Neuro Oncol Date: 2010-12-22 Impact factor: 12.300
Authors: Sophie Wilne; Jacqueline Collier; Colin Kennedy; Anna Jenkins; Joanne Grout; Shona Mackie; Karin Koller; Richard Grundy; David Walker Journal: Eur J Pediatr Date: 2011-05-20 Impact factor: 3.183
Authors: Marco Ronald Hassler; Katarzyna Elandt; Matthias Preusser; Johann Lehrner; Petra Binder; Karin Dieckmann; Andrea Rottenfusser; Christine Marosi Journal: J Neurooncol Date: 2009-09-10 Impact factor: 4.130
Authors: Zsila S Sadighi; Elizabeth Curtis; Jennifer Zabrowksi; Catherine Billups; Amar Gajjar; Raja Khan; Ibrahim Qaddoumi Journal: Pediatr Blood Cancer Date: 2018-05-09 Impact factor: 3.167
Authors: Ata U R Maaz; Tayseer Yousif; Ayman Saleh; Ian Pople; Khalid Al-Kharazi; Jehan Al-Rayahi; Naser Elkum; Muzaffar Malik Journal: Childs Nerv Syst Date: 2020-07-24 Impact factor: 1.475
Authors: Cliodhna Carroll; Peter Watson; Helen A Spoudeas; Michael M Hawkins; David A Walker; Isabel C H Clare; Anthony J Holland; Howard A Ring Journal: Neuro Oncol Date: 2013-03-15 Impact factor: 12.300