Pediatric Nervous System Tumors

What are the two main categories of nervous system tumors discussed, and what percentage of childhood cancers do CNS tumors represent?

The two main categories are brain tumors and neuroblastoma. CNS tumors account for approximately 25% of childhood cancers.

How are brain tumors in children classified based on location?

They are classified as Infratentorial tumors (involving the cerebellum and brainstem) and Supratentorial tumors (mainly occurring in the cerebrum).

What are key components of the diagnostic evaluation for nervous system tumors in children?

Assessing signs and symptoms related to tumor location, size, age, presenting clinical signs, and diagnostic procedures like MRI, CT scan, EEG, and lumbar puncture.

What is the definitive method for diagnosing nervous system tumors?

The definitive diagnosis is based upon specimens obtained during surgery.

What does a neurologic examination in children include?

Assessment of vital signs, skin, eyes, motor function, posturing, reflexes, occipitofrontal circumference, fontanelles, and developmentally appropriate commands.

What are signs and symptoms of increased intracranial pressure (ICP) in infants?

Signs include tense, bulging fontanel, separated cranial sutures, Macewen sign, irritability, drowsiness, and increased sleeping.

What are common signs and symptoms of increased ICP in children?

Headache, nausea, forceful vomiting, diplopia, seizures, indifference, declining school performance, and inability to follow commands.

What comprises Cushing's Triad, and what does it indicate?

Cushing's Triad includes bradycardia, irregular respirations, and hypertension. It indicates late signs of increased intracranial pressure.

What are general therapeutic management options for nervous system tumors in children?

Options include surgery, radiotherapy, chemotherapy, or combinations, depending on the type of tumor.

What are key aspects of care management for children with nervous system tumors?

Preparing the child and family for procedures, considering body image impact, preventing complications, and providing support.

What are important elements of post-operative care for children after surgery for nervous system tumors?

Neurochecks, seizure prophylaxis, managing external drains, infection prophylaxis, appropriate positioning, nutrition, and pain management.

How can severe post-operative headaches be managed non-pharmacologically?

Managing may include providing a quiet environment, restricting visitors, applying ice packs, and preventing jarring and increases in ICP.

What is neuroblastoma and where do these tumors most commonly develop?

Neuroblastoma is the most common malignant extracranial solid tumor of childhood, primarily developing in the adrenal gland or retroperitoneal sympathetic chain.

What is the primary objective of the diagnostic evaluation for neuroblastoma?

To locate the primary site and sites of metastasis.

What methods are used to diagnose neuroblastoma?

Methods include skeletal surveys, radiologic studies, bone marrow evaluation, and intravenous pyelography.

What are the main components of therapeutic management for neuroblastoma?

Includes clinical staging, surgery, radiation, chemotherapy, bone marrow transplantation, and stem cell rescue.

What are survival rates for low-risk and high-risk neuroblastoma at 5 years?

95% survival for low-risk disease and 30% survival for high-risk. Younger patients at diagnosis generally have better prognosis.

What describes the pathophysiology of nervous system tumors?

It involves abnormal growth of cells in neural tissue leading to increased ICP, causing symptoms like headache, vomiting, and neurological deficits.

What factors influence the prognosis of CNS tumors?

Factors include type and location of the tumor, extent of resection, and response to therapy.

What nursing interventions are important pre-operatively for children with nervous system tumors?

Preparing the child and family for tests and surgery, assessing impact on body image, and providing psychological support.

What nursing priorities are focused on post-operatively for a child with a nervous system tumor?

Frequent neurochecks, seizure and infection prophylaxis, managing drains, ensuring proper positioning, nutrition, and emotional support.

What promotes a return to optimum functioning in children with nervous system tumors?

Providing continuous emotional support and addressing physical and psychological needs throughout the course of care.