Bianchi E, Podestà A F, Aricò M
Minerva Med. 1984 Jun 8;75(24):1407-11.
Brain tumors are, after leukemias, the most frequent fatal neoplasms of infancy. The clinical features and symptoms are often markedly different from those observed in the adult forms, according to the peculiar anatomy and behaviour of the child. Persistent headache, vomiting, astenia , behavioral alterations may be the precocious findings. Later, some more specific and suggestive signs such as strabismus, dyplopia , fast head size increase, funduscopic alterations, ataxia, paresis and nystagmus may be observed. On their appearance a prompt diagnostic work-up should be performed. The tumors of the posterior fossa (cerebellar astrocytoma and medulloblastoma, brainstem glyoma , hependimoma in decreasing order of frequency) generally cause precocious symptoms because of the small dimension of the subtentorial space; the presence in this region of several fundamental nuclei and pathways may explain how also small tumors may cause severe deficits. Supratentorial tumors (astrocytoma, malignant glyoma , hependimoma , craniofaringioma ) often show a more prolonged latency and may begin with signs of endocranial hypertension, seizures, or sometimes with hormonal troubles according to the involved anatomic structures. Hypothalamic astrocytoma is responsible of an extreme weight loss as far as to a cachetic status, due to the hyperincretion of GH. Finally, plexus papilloma, dermoid, optic nerve glyoma , oligodendroglyoma , germinoma, teratoma are responsible of a small number of child brain tumors, with different localization and symptomatology.
脑肿瘤是继白血病之后婴儿期最常见的致命性肿瘤。根据儿童独特的解剖结构和行为特点，其临床特征和症状往往与成人型明显不同。持续性头痛、呕吐、乏力、行为改变可能是早期表现。之后，可能会观察到一些更具特异性和提示性的体征，如斜视、复视、头围快速增大、眼底改变、共济失调、轻瘫和眼球震颤。一旦出现这些症状，应立即进行诊断性检查。后颅窝肿瘤（小脑星形细胞瘤、髓母细胞瘤、脑干胶质瘤、室管膜瘤，按发生频率递减排列）通常会因幕下空间狭小而导致早期症状；该区域存在多个重要神经核团和神经通路，这可以解释为何小肿瘤也可能导致严重功能障碍。幕上肿瘤（星形细胞瘤、恶性胶质瘤、室管膜瘤、颅咽管瘤）通常潜伏期较长，可能开始表现为颅内高压、癫痫症状，有时根据受累解剖结构还会出现激素紊乱症状。下丘脑星形细胞瘤由于生长激素分泌过多，可导致极度体重减轻，甚至恶病质状态。最后。乳头状瘤、皮样囊肿、视神经胶质瘤、少突胶质细胞瘤、生殖细胞瘤、畸胎瘤导致的儿童脑肿瘤数量较少，其定位和症状各不相同。
