Brain Tumors in Children: Symptoms, Diagnosis & Treatment

There are many types of brain tumors in children. Some are fast-growing and are malignant (cancerous), while others grow slowly and are benign. All of them can be frightening and life-altering for the child and their family. Centers for Neurosurgery, Spine & Orthopedics (CNSO), New Jersey’s most comprehensive brain and spine center, offers hope with state-of-the-art brain tumor care, helping young patients achieve the best outcomes.

Quick Facts About Brain Tumors in Children

• Brain tumors are constantly growing masses of abnormal cells in the brain. There are several types of brain tumors that are common in children.
• Symptoms of brain tumors depend on their size and type. Parents should watch for morning headaches, vomiting, sensory changes, behavioral changes, balance loss, and seizures.
• Treatment options for brain tumors in children include surgery, radiation therapy, chemotherapy, and targeted therapy, depending on the tumor’s size and type.
• Rehabilitation, support, and education systems exist to help families navigate a childhood brain tumor diagnosis.

Overview of Pediatric Brain Tumors

Brain tumors are masses of abnormal cells that form from cells of the brain or surrounding structures. This mass may grow quickly or slowly, but it does not stop getting larger, causing pressure on or invading nearby brain structures. This causes injury and dysfunction that may be irreversible and permanent. Some brain tumors are malignant and can spread into other tissues. Other tumors are benign; however, even benign brain tumors are serious medical conditions that require prompt evaluation and treatment.

Types of Brain Tumors in Children

Types of brain tumors are distinguished by the brain tissue from which they originate. There are many types of brain tumors that affect children, including:

• Medulloblastoma: A medulloblastoma is considered a central nervous system (CNS) tumor because it originates from embryonal neuroepithelial cells, which are remaining fetal brain cells. It is a cancerous brain tumor that can rapidly spread to other parts of the CNS system, such as the spinal cord. It typically arises from the back of the brain and can block the normal fluid pathways, causing hydrocephalus (or water on the brain). Classically, children with a medulloblastoma present with severe headaches, nausea, and vomiting.
• Ependymoma: An ependymoma begins in the ependymal cells in the brain and spinal cord. These cells line the passageways where cerebrospinal fluid (CSF) is located. Ependymomas can occur nearly anywhere in the brain or spinal cord, but most often originate in the fourth ventricle, in the back of the brain, or the bottom of the spinal cord. Like medulloblastomas, they often cause headaches, nausea, and vomiting, and can metastasize throughout the CSF, spreading to other parts of the brain and spinal cord.
• Astrocytoma: Astrocytes are a type of glial (support) cell in the brain and in the spinal cord. If astrocytes begin to grow excessively, they can form into a tumor called an astrocytoma. A juvenile pilocytic astrocytoma (JPA) is the most common occurring astrocytoma in children and young adults. A JPA is a Grade I or truly benign tumor that can be cured with surgery. Grade II, or low-grade astrocytomas, and Grade III and IV astrocytomas, known as anaplastic astrocytoma and glioblastoma (GBM), are all malignant brain tumors. Grade II astrocytomas are slow-growing with a much better prognosis than anaplastic astrocytomas and GBMs.
• Oligodendroglioma: This tumor begins in glial cells called oligodendrocytes. The oligodendrocytes produce myelin, which is a protein that protects and aids axons in their transmission of neuronal impulses throughout the brain. 
• Pineal tumor: Pineal region tumors are rare masses that form in the pineal gland. This disease mostly affects children and young adults.
• Pituitary tumor: A pituitary tumor is an abnormal growth of the gland that can occur in adults. If the tumor remains small, it might not cause any symptoms. As a result, it may only be found incidentally on an imaging test, such as an MRI of the head or neck. If it continues to grow, however, it can begin to place pressure on nearby nerve structures.
• Craniopharyngioma: This is a slow-growing, benign brain tumor located in the central region of the brain, arising from the pituitary stalk. These cystic tumors grow slowly, but as they enlarge, they put pressure on the optic nerves, causing visual loss and damage to the pituitary and pituitary stalk, resulting in a loss of hormone function.
• Choroid plexus tumor: Choroid plexus tumors form within the ventricular system, a system of fluid-filled channels within the brain. The tumors originate from the cells within the choroid plexus, tissue that produces cerebrospinal fluid, which fills the ventricles in the brain and surrounds the brain and spinal cord. Most often found in children up to two years old, choroid plexus tumors rarely affect adults.
• Meningioma: These tumors arise from the cells of the covering of the brain (meninges) and typically are benign. They are slow-growing and only cause symptoms when they are large enough to press on the brain and cause dysfunction. Although meningiomas are a very common type of brain tumor, they occur almost exclusively in adults and rarely in children.
• Vestibular schwannoma (also known as acoustic neuroma): Vestibular schwannomas grow out of the vestibular nerve that originates in the brainstem and travels into the inner ear through a canal in the skull base called the internal auditory canal. The vestibular nerve is in close proximity to the cochlear nerve (hearing) and facial nerve (facial movement), and, therefore, as vestibular schwannomas grow, they can cause tinnitus, hearing loss, facial weakness, dizziness, and balance disorders. Large vestibular schwannomas can be life-threatening. These types of tumors can be seen in older children but are much more common in adults.

Causes and Risk Factors for Brain Tumors

Tumors are caused by a DNA change that causes uncontrolled cell growth and reproduction. Physicians are not always sure what provokes this change. Some tumors may be related to genetic conditions, for instance, neurofibromatosis, a rare inherited mutation. Others are caused by problems in embryonic development, where fetal epidermal (skin) cells become trapped in the brain, where they grow and become a tumor.

Common Symptoms of Brain Tumors in Children

Very small tumors often do not cause any symptoms. As the tumor grows larger, it begins to interfere with brain function, causing new symptoms to gradually develop. It can be difficult to identify symptoms in young children who may not be able to express what they are feeling. Parents should watch for:

• Headaches that are worse at night and early morning
• Nausea and vomiting, especially without diarrhea
• Excessive sleepiness
• Arm or leg weakness on one side of the body
• Issues with vision, hearing, or speech
• Balance issues
• Lack of coordination
• Increase in head size, especially in infants
• Sudden changes in behavior
• Seizures

Parents who notice any significant changes in their child’s health should seek prompt medical attention. The sooner a brain tumor is diagnosed and treated, the better the prognosis and overall outcome.

Diagnostic Tests for Pediatric Brain Tumors

Physicians must first know the exact type, location, and size of a tumor before they can plan an effective treatment. This requires a thorough medical evaluation. Brain tumor specialists use multiple types of tests to diagnose brain tumors, including:

• Medical history: The physician speaks with the patient and their parents to learn more about the tumor’s symptoms, what triggers them, and how long they have been present.
• Neurological exam: This is a type of physical examination used to test neurological functions such as senses, motor ability, reflexes, coordination, and mental status.
• Medical imaging: Magnetic resonance imaging (MRI) scans provide the most detailed images of brain structures, making this the preferred imaging method for locating brain tumors.
• Biopsy: When a brain tumor is located in an area that would be dangerous to remove, a biopsy is often recommended. With the help of image-guided navigation, the surgeon uses a needle to remove a small amount of brain tumor tissue for evaluation in a medical laboratory.

Treatment Approaches for Brain Tumors in Children

Once a brain tumor has been diagnosed, physicians can plan treatment. The best treatment depends on a variety of factors, including the type of tumor, its size, and location in the brain. Options include:

Surgery

Brain tumor surgery is the preferred and most effective treatment for the vast majority of tumors that occur in children. The neurosurgeon removes as much of the tumor as possible to relieve pressure and prevent new symptoms from developing. CNSO offers both open and minimally invasive craniotomy and endoscopic brain surgery.

Radiation Therapy in Children

Radiation therapy targets tumor cells with a highly concentrated beam of radiation, killing the tumor to prevent further growth. It is not always recommended for children as it may cause developmental delays. CNSO partners with radiation oncologists to determine the best treatment options for our pediatric brain tumor patients.

Chemotherapy and Targeted Therapies

Chemotherapy is almost always used in conjunction with surgery and radiation therapy to treat malignant pediatric brain tumors. It employs strong drugs to kill fast-growing cells and shrink the tumor. Some patients may also be candidates for targeted therapy. This advanced approach uses molecular medicine to precisely attack tumor cells while sparing healthy tissue.

Support for Families and Patients

A brain tumor diagnosis is frightening and life-altering for patients and their families alike. There may be challenging symptoms and side effects, lifestyle adjustments, and fears about potential outcomes. In addition, tumor treatment is often disruptive to a child’s education and social opportunities.

Emotional and Educational Support

Families struggling with a pediatric brain tumor should remember that they are not alone. Professional and community resources exist to provide emotional support and connection. There are also educational aids that can help children keep up with their schooling while receiving treatment, which help them maintain a sense of normalcy and prepare them for normal life after treatment. The Pediatric Brain Tumor Foundation can connect families with financial assistance, educational aids, and support groups.

Why Choose CNSO?

When a child is diagnosed with a brain tumor, their family looks for the highest quality of care available. Centers for Neurosurgery, Spine & Orthopedics is New Jersey’s most comprehensive brain and spine center, led by an award-winning team of neurosurgeons, oncologists, rehabilitation specialists, and more. CNSO takes a personalized and conservative approach to care that uses invasive treatments only when necessary to ensure positive results, prioritizing the child’s well-being.

Find Expert Pediatric Brain Tumor Care Near You in New Jersey

A brain tumor is frightening, but there is hope with the right medical care. Centers for Neurosurgery, Spine & Orthopedics treats brain tumors in children at convenient locations near you across New Jersey, including Bergen, Passaic, Essex, Morris, Union, Middlesex, and Hudson counties. To learn more about care options or to schedule an appointment, contact CNSO today.

FAQ About Brain Tumors in Children

How does brain tumor treatment differ for children vs. adults?

The same treatments are used for both children and adults with brain tumors. Treatment goals for children focus more on preserving brain health, while goals for adults are to control tumor growth.

What support is available for families?

Organizations like the Pediatric Brain Tumor Foundation can connect families with financial assistance, educational aids, support groups, and more.

What is the prognosis for children with brain tumors?

Brain tumor prognosis depends on the tumor type and location. Many pediatric brain tumors are curable, however, allowing patients to live full lives afterward.

Can brain tumors in children be prevented?

Brain tumors in children cannot be prevented. With a prompt response, however, patients can improve the likelihood of successful treatment.