J.Jpn. Surg. Soc.. 58(1): 71-89, 1957

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CLINICAL STUDIES OF INTRACRANIAL TUMORS IN PEDIATRIC AGE GROUP

From surgical point of view, 74. cases of intracranial tumors in pediatric age group who were admitted and treated in our clinic during the period of 19 years from 1937 to 1955 were analized. These cases correspond to 27.6% of all cases of intracranial tumors. Although infratentorial tumors show higher percentage than supratentorial ones in many foreign statistics, in our series of 74 tumors, 41 cases (55.4%) were supratentorial, and 33 cases (44.6%) infratentorial.
Concerning the kinds of tumors it is important that in general the glioma shows the highest percentage in all intracranial tumors in this age group. In our series also gliomas had the highest incidence, namely 67.6%, which is, however, still lower than foreign cases, but the incidence of craniopharyngiomas and tuberculomas are higher than fo reign statistics. Almost all intracranial tumors which occur in infancy and childhood are three kinds mentioned above.
The incidence of brain tumor that occur along the central neural axis is as high as 44.6% comparing with the incidence of 12.7% in adult, and this is the one of the charactaristics of intracranial tumors in infancy and childhood.
Marked initial and general symptoms were headache and vomiting (projectile or not), due ot increased intracranial pressure, and chocked disc found in 60.8% of all cases by ophthalmoscopic examination.
The interval period from onset of initial symptoms to the first visit to our clinic was shorter than that of adult, namely 78% of all patients came within 1 year, and this interval period in subtentorial tumors is far shorter than that of supratentorial.
70.3% of all cases were able to be justified the localization of tumor by way of general neurological examination and craniography, and with the additional aid of ventriculography, this became possible in 96.2%
Though operative procedures were done in 53 cases, total and subtotal resection of tumors were performed only in 16 cases.
Operative motality was 24.5% but it became down to 4.2% during late 5 years.
Postoperative radiation therapy was effective in 17 cases among 30 received, however, we cannot expect improvement of symtoms except in the case of medulloblastoma.
The frequency of epileptic seizure due to brain tumor was as same as that of adult and was found in 33.8%, among which 62.5% was improved by operatien. Postoperatively 12.5% of these was resulted in epileptic seizure. This epileptic seizures were more frequent in cerebral meningioma than in cerebrel glioma.
Postoperative follow-up was done in 39 cases concerning postoperative functional abnormalities, average living interval and average length of useful life.
(author's abstract)

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