Related Experiment Videos
[Vomiting as a first neurological sign of brain tumors in children]
R F Bos1, C Ramaker, W J R van Ouwerkerk
1Afd. Kindergeneeskunde, Sint Lucas Andreas Ziekenhuis, Postbus 9243, 1006 AE Amsterdam. k.ramaker@slaz.nl
Insights
Persistent vomiting in children may signal a brain tumor. Early CT scans are crucial for diagnosis, as neurological signs can be absent, leading to timely intervention and improved outcomes.
Area of Science:
- Pediatric Neurology
- Pediatric Oncology
- Neuroimaging
Background:
- Vomiting is a common symptom in children, often attributed to gastrointestinal or infectious causes.
- Intracranial pathology can induce vomiting through increased intracranial pressure or direct brainstem stimulation.
- Brain tumors in pediatric patients may present with non-specific symptoms, complicating early diagnosis.
Observation:
- Four children (aged 1.5-10 years) presented with prolonged vomiting (1-4 weeks).
- Additional neurological signs like ataxia and head tilt were noted in some cases.
- Computed Tomography (CT) scans revealed brain tumors in all four children.
Findings:
- Surgical intervention was performed for all diagnosed brain tumors.
- Complete tumor excision with no recurrence was achieved in two patients over 2 years.
- One patient experienced tumor recurrence and metastasis despite adjuvant therapy, succumbing to the disease.
- One patient had residual tumor post-surgery that did not cause further complications.
Implications:
- Chronic or intractable vomiting without other typical symptoms warrants investigation for intracranial processes, including brain tumors.
- Prompt neuroimaging is essential for diagnosing pediatric brain tumors, even in the absence of overt neurological deficits.
- The study highlights the critical role of early detection and intervention in pediatric brain tumor management.
Abstract:
Four children (two boys aged 1.5 and 10 years and two girls aged 2 and 9 years) vomited for one-half to four weeks. In one child, ataxia was later also noted and another tilted his head constantly to the left, but this was initially not alarming. In all four cases CT revealed a brain tumour, for which they were operated. Postoperatively, one child had residual tumour tissue that caused no further problems, in two children the tumour was completely excised with no further symptoms and no recurrence in the following 2 years, and in one child complete excision was not possible so that chemotherapy and radiotherapy were given, but metastases nevertheless developed 10 months later and the child died. Vomiting is common in children and in most cases the result of infectious or gastrointestinal causes. Intracranial pathology also can cause vomiting, both by increased intracranial pressure and by direct stimulation of the vomiting centre in the brainstem. Brain tumours in children often lack specific neurological signs in their clinical presentation. Intractable or chronic vomiting without nausea or deregulation of the water and electrolyte balance could therefore indicate the presence of an intracranial process, even when other neurological signs are absent.
Related Concept Videos
01:18Viral Meningitis
01:26Brain Abscess l: Introduction
01:15Equilibrium and Balance
01:11Pyloric Obstruction