Central nervous system tumor (peds): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
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***[[Headache]] | ***[[Headache]] | ||
****Early morning (sleep > hypoventilation > hypercarbia > incrreases CNS bloodflow > inreaced ICP) | ****Early morning (sleep > hypoventilation > hypercarbia > incrreases CNS bloodflow > inreaced ICP) | ||
***Effortless vomiting | ***Effortless [[vomiting]] | ||
*** | ***[[Cranial nerve palsies]] (especially 6th nerve) | ||
**Brainstem | **Brainstem | ||
***CN deficits (facial weakness, abducens palsy, dysphagia), ataxia | ***CN deficits (facial weakness, abducens palsy, dysphagia), ataxia | ||
**Supratentorial | **Supratentorial | ||
***Headache, personality change, motor weakness, [[seizure]] | ***Headache, personality change, motor [[weakness]], [[seizure]] | ||
**Sellar | **Sellar | ||
***Visual changes, hypothalamic dysfunction (DI, stunted growth, hypothyroidism) | ***Visual changes, hypothalamic dysfunction (DI, stunted growth, hypothyroidism) | ||
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==Management== | ==Management== | ||
*[[Increased ICP]] | *[[Increased ICP]] | ||
**Phenytoin if actively seizing | **Phenytoin, benzodiazepines if actively seizing | ||
**Dexamethsone 1mg/yr of age (max 10mg) | **[[Dexamethsone]] 1mg/yr of age (max 10mg) | ||
***Do NOT give if CNS lymphoma is in the differential | ***Do NOT give if CNS lymphoma is in the differential | ||
==See Also== | ==See Also== | ||
*[[Herniation Syndromes]] | *[[Herniation Syndromes]] | ||
*[[Elevated ICP]] | |||
==References== | ==References== | ||
Revision as of 04:49, 12 September 2016
Background
- 2nd most common pediatric cancer (20%)
Clinical Features
- Depends on location
- Posterior Fossa
- Headache
- Early morning (sleep > hypoventilation > hypercarbia > incrreases CNS bloodflow > inreaced ICP)
- Effortless vomiting
- Cranial nerve palsies (especially 6th nerve)
- Headache
- Brainstem
- CN deficits (facial weakness, abducens palsy, dysphagia), ataxia
- Supratentorial
- Sellar
- Visual changes, hypothalamic dysfunction (DI, stunted growth, hypothyroidism)
- Posterior Fossa
Differential Diagnosis
Pediatric Headache
- Primary headache
- Secondary headache
Evaluation
Management
- Increased ICP
- Phenytoin, benzodiazepines if actively seizing
- Dexamethsone 1mg/yr of age (max 10mg)
- Do NOT give if CNS lymphoma is in the differential