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Query: UMLS:C0004134 (ataxia)
 15,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We examined potential clinical and pathologic correlates of seizures among the 3,291 children in the Childhood Brain Tumor Consortium database. Fourteen percent had seizures prior to their hospitalization for a brain tumor. Among children who had a supratentorial tumor, seizures occurred in 22% of those less than 14 years of age. The prevalence of seizures increased to 68% of older teenagers. Among children with an infratentorial tumor, the prevalence of seizures was relatively constant at 6% over all age groups. The onset of seizures began more than one year prior to surgical tumor removal in over half of the children aged five or more with supratentorial tumors, significantly longer than for those of the same age with infratentorial tumors. Almost all children (98.9%) with an infratentorial tumor and seizures had at least one other symptom and more than three-fourths of them had at least three. Eighty-nine percent of children with a supratentorial tumor and seizures had at least one other symptom and more than one-half had at least three symptoms. Regardless of whether the tumor was above or below the tentorium, confusion or stupor and coma were more common in children with seizures than in children without seizures. Among children with supratentorial tumors, symptoms of a declining academic performance or an abnormality of personality, speech, walking, or sensation were significantly more frequent in children with seizures, while visual symptoms (other than visual loss or diplopia) and nausea or vomiting were less frequent. Among children with supratentorial tumors, those who had seizures were more likely to have paralysis of an arm, hand, or face, confusion or stupor, or coma and less likely to exhibit irritability, papilledema, optic atrophy, decreased visual acuity, pupillary abnormalities, or abducens paresis. Among children with infratentorial tumors, those with seizures were significantly less likely to have truncal ataxia, but more likely to experience confusion, stupor, or coma. In the supratentorial compartment, astrocytoma (nos), protoplasmic astrocytoma, anaplastic astrocytoma, and ependymoma were more frequently associated with seizures than was craniopharyngioma. No infratentorial tumor type was more or less likely to be associated with seizures. All common tumor types that were represented in both the supratentorial and the infratentorial compartment except astrocytoma (nos) were associated with significantly greater rates of seizures when located in the supratentorial compartment. The tumor location with the highest incidence of seizures was, as expected, the superficial cerebrum. More than 40% of the children with such tumors had seizures.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Epidemiology of seizures in children with brain tumors. The Childhood Brain Tumor Consortium. 154 79

we report a patient with Wallenberg's syndrome caused by glioma of the lateral medulla oblongata, and review the literature for Wallenberg's syndrome associated with neoplastic disease. A 46-year-old man was admitted because of progressive dysphagia and vertigo. Neurological examination revealed atypical symptoms and signs of Wallenberg's syndrome on the right side, hypalgesia on the second and third divisions of the left trigeminal nerve, paresis of the right palate and uvula, and ataxia of the right extremities. Although CT showed no abnormality in the posterior fossa, MRI demonstrated a mass with abnormal signal intensities in the right dorsolateral portion of the medulla. Biopsy specimens showed astrocytoma (grade III). Based on the present case and a review of 10 previously reported cases of Wallenberg's syndrome caused by neoplastic disease, the clinical features of this syndrome are characterized by gradual development and steady progression of symptoms, non-classical or atypical symptomatology, numerous additional symptoms and signs depending on the site and size of tumors, and poor prognosis.
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PMID:[Wallenberg's syndrome caused by a brain tumor--a case report and literature review]. 216 89

Brain stem glioma is the third most common childhood brain tumor, comprising 10-15% of this group of neoplasms. Typical presenting symptoms include ataxia, diplopia and headache, while signs of increased intracranial pressure occur later in the clinical course. Although prolonged failure to thrive, characterized by cachexia and vomiting are rare manifestations of brain stem lesions, in this study we report a 9.5-year-old boy with failure to thrive since infancy which remitted after excision of a brain stem astrocytoma.
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PMID:Chronic dysphagia, vomiting and gastroesophageal reflux as manifestations of a brain stem glioma: a case report. 248 55

Brainstem tumors arise in portions of the rhombencephalon and mesencephalon. Some authorities include diencephalic tumors in this group. We have reviewed our clinical experience of 69 children (less than 21 years of age) with brainstem tumors evaluated and treated at Duke University Medical Center (DUMC) from 1960 to 1986. There were 19 patients with group 1 tumors (thalamus, third ventricle region, or midbrain) and 50 with group II tumors (pons, medulla oblongata). The common presenting signs and symptoms were ataxia, headache, motor loss, and cranial nerve palsies. The most commonly employed diagnostic imaging studies were air examinations and CT. Preradiotherapy confirmation of malignancy was obtained in five group I patients (astrocytoma, 4; germinoma, 1) and 8 group II patients (astrocytoma, 3; anaplastic astrocytoma, 2; glioblastoma multiforme, 3). All patients received radiotherapy. The 5-year survival rate for the entire population was 40%. The survival rate for group I patients was significantly better than that observed for group II patients. In the 50 group II patients neither patient sex nor age nor presence of cranial nerve palsies nor pretreatment CT scan findings nor field size influenced survival. A long duration of symptoms positively influenced survival. The vast majority of tumor recurrences were within the radiation field. Half of the patients had either stable or improved Karnofsky status 6 months following completion of irradiation. The management strategy for childhood brainstem tumors is discussed.
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PMID:Selection of a management strategy for pediatric brainstem tumors. 270 33

Among 100 childhood brain tumors treated at Kobe Children's Hospital from May 1970 to June 1985, 18 of the children presented with symptoms during the first year of life. This paper analyzes these 18 cases. Supratentorial tumors (78%) were more common than infratentorial ones, and 67% of all the tumors were located in the central neural axis. Initial symptoms were cranial enlargement (56%), vomiting (17%), cranial deformity (11%), blepharoptosis, respiratory distress, and ataxia. Histological diagnosis of the tumors was as follows: teratoma (3 cases), medulloblastoma (3), glioblastoma (2), astrocytoma (2), ependymoma (2), craniopharyngioma (1), choroid plexus papilloma (1), hamartoma (1), lipoma (1), melanotic progonoma (1), and an undetermined type, probably medulloblastoma (1). Seventeen of the patients underwent craniotomy for tumor resection (4 total, 4 subtotal and 7 partial removal, and 2 biopsies). Additional therapeutic methods used separately and in various combinations included ventriculoperitoneal shunt, subduralperitoneal shunt, ventricular drainage, radiotherapy and chemotherapy. Nine patients died (average 98 days) after surgery. Of the 9 survivors, 6 are still alive after more than 5 years. Five of the 6 are mentally retarded and 4 are physically handicapped to some degree.
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PMID:Intracranial tumors in the first year of life. 377 67

A 2-year-old Duroc boar was examined because of weakness, ataxia, and blindness. During hospitalization, fever spikes of about 41.6 C (107 F) were recorded every 24 hours. The tentative diagnosis was a space occupying mass in the diencephalon. The boar's condition deteriorated rapidly, so the boar was euthanatized and necropsied. On the basis of gross and histopathologic findings, as well as cell marker-specific-staining characteristics, astrocytoma was diagnosed.
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PMID:Astrocytoma in a boar. 405 5

Four cases of gliomatosis cerebri are reported that demonstrate the variability of the clinical course. A review of these and 32 cases from the literature revealed that the most striking finding was change in personality and mental status. Hemiparesis, ataxia, papilledema, headache, seizure, and brainstem signs were the next most common clinical findings. Laboratory and radiographic tests, including angiography and pneumoencephalography, often showed only minor and nonspecific changes in the face of profound mental deterioration. Increased intracranial pressure usually occurred late but was probably an important factor of the terminal course in most patients. The pathologic changes were typical, with diffuse infiltration of astrocytoma cells through brain stem, subcortical white matter, and, to a lesser extent, cerebral cortex.
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PMID:Gliomatosis cerebri. Report of four cases and review of the literature. 449 66

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.
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PMID:[Clinical course of brain tumors in childhood]. 673 95

The symptomatological investigations on 20 cases of cerebellar astocytoma were carried out. These cases, observed and treated in Hokkaido University Hospital from 1959 to 1978, were divided into two groups, such as childhood group (under 15 years old) and adult group (over 16 years old). The following conclusions were obtained: (1) The youngest was 2 years old and the oldest was 64 years old. The age distribution showed higher incidence in younger age group under the age of 30, especially in the first decade. (2) The most frequent symptoms were vomiting, headache and unsteady gait in all cases, but vomiting was constantly seen in childhood cases. (3) The average length of history in children was 2.4 months in childhood, and 17.6 months in adult cases. (4) Neurological signs on admission could be summarized as follows. The signs indicating increased intracranial pressure was most frequent, and the next common findings were ataxia of the limbs and trunk. Impairment of the cranial nerves and brainstem were uncommon. On neurological signs there was little difference between in children and in adults. (5) The total cases of complete removal of the tumor were many, but in adults there were not a few cases in which incomplete removal of the tumor was accomplished. (6) The majority of cerebellar astrocytoma were cystic and laterally placed in the cerebellum especially in children. (7) Microscopically in children, the frequent type was pilocytic astrocytoma of juvenile type. (8) The result of surgical removal of cerebellar astrocytoma was excellent, and the long-term survivours were found frequently and the quality of survival was good. The follow-up results in children were better than those in adults.
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PMID:[A clinical survey of cerebellar astrocytoma--comparison between childhood and adult cases (author's transl)]. 736 Mar 6

Cerebellar astrocytoma accounted for 10% of all brain tumours treated at the Department of Neurosurgery, Medical Academy in Cracow in the years 1946 to 1968. It accounted for 16.6% of all gliomas, and 57% of subtentorial gliomas. Table I shows the distribution of the tumour according to age groups. The male:female sex ratio was near 1.0. In 124 cases the tumour was situated in the cerebellar hemispheres and in 91 in the vermis. The present study is based on an analysis of 215 cases with 124 tumours in the hemispheres and 91 in the vermis. In the hemispheres 77.8% of astrocytomas had cavities, while 22.2% were solid. In the vermis 60.6% of the tumours had cavities and 39.4% had no cavities. Infiltration of the brain stem or adherence to the floor of the fourth ventricle are mentioned in the protocols of 19 operations. The most frequent tumour in childhood and adolescence was pilocytic astrocytoma, in adulthood fibrillary and protoplasmic astrocytomas prevailed. In 10 cases of the last mentioned variety evidence of anaplasia was found. In the first four years when all operations were performed under local analgesia or rectal general anaesthesia the operative mortality was 21.5%, and in the subgroup of 40 first cases it was even 25%. After introduction of endotracheal anaesthesia the operative mortality fell to 13%, and in the subgroup of 40 last cases it was 9%. Detailed data about follow-up observations are available in 93 cases. Thirteen of them were disabled because of complete or nearly complete loss of vision. Nine of them completed schools for the blind and work in gainful occupations ad two founded families. Three patients are completely disabled because of equilibrium disturbances and ataxia. Two children attended a special school. The remaining 85 patients regarded themselves as healthy. This group comprised 66 patients operated upon at the age from 2 to 14 years, 12 were treated at the age from 15 to 21 years and 7 above that age. Some of them had high school education, others were doing heavy manual work, and many others attended secondary or high schools. Among the female patients 13 were mothers who gave birth to 23 children. (Table I). The fates of our patients confirm the view that in most cases cerebellar astrocytoma is surgically curable. The limit of radical operation is finding of brain stem infiltration observed in about 11% of cases. Partial removal of the tumour does not protect against recurrence but in some cases symptom-free periods of many years' duration were reported.
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PMID:[Immediate and remote results of treatment of cerebellar astrocytoma]. 745 25


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