Disease.Anatomy.Presenting Symptoms

Disease Overview
Anatomy & Clinician Significance
The Central Nervous System
Brain Anatomy
The Ventricular System
Presenting Symptoms

Disease Overview

dulloblastomas can affect individuals of any age, but occur most often in children under the age of 15 with a peak incidence between 3 and 9 years of age. dulloblastomas are the most common malignant brain tumor in children. Approximately 80 percent of affected individuals are under the age of 15. dulloblastomas are extremely rare in adults accounting for 1-2 percent of all cases of brain tumors in adults. In adults, most medulloblastomas occur in individuals between 20-44 years of age. dulloblastomas are extremely rare in individuals over the age of 45.

In children, males are affected more often than females. However, in adults the ratio is the same. The exact incidence of dulloblastomas is not known and many different estimates are given the
medical literature. Generally, dulloblastomas account for 2 percent of all primary brain tumors and 18 percent of all pediatric brain tumors. Approximately 1,000 new cases are diagnosed in children and adults each year in the United States.

What is
dulloblastoma?

dulloblastoma is a primary central nervous system (CNS) tumor. This means it begins in the brain
or spinal cord. To get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if
possible. dulloblastoma begins in different cells in the cerebellum, which is the back of the brain.
The cerebellum controls body movement and coordination.

Who gets
dulloblastoma?

dulloblastoma occurs most commonly in children. dulloblastoma is more common in boys
than in girls.and occurs most often in the first 8 years of life, with about half of cases occurring in
children younger than 6 years old.

Why does anyone get
dulloblastoma?

most brain and spinal cord tumors occur randomly and have no apperant cause. Genetic factors &
environmental factors may play a part. Certain gene and chromosome changes within the tumor
cell are associated with the development of dulloblastoma . Usually, it is not known why these
genetic changes occur.

Anatomy & Clinical Significance

It is important to know where the tumor is located within the brain and/or the spine so you can understand what symptoms may occur. The biology may also be different based on the location. During treatment, your health care team will use many terms to refer to locations in the head, neck and spine. The diagrams in this section will help you locate different parts of the brain and spine.

The Central Nervous System Brain Anatomy The Ventricular System

The Central Nervous System

The brain and spinal column make up the central nervous system (CNS), where all vital functions are controlled. These functions include thought, speech, and body movements. This means that when a tumor grows in the CNS, it can affect a person’s thought processes or the way they talk or move. dulloblastoma is the most common CNS tumor and originates in the cerebellum.

All Central Nervous System Pediatric Cancers

Brain and spinal cord tumors are the 2nd most common type of cancer in children after leukemia. Approximately 20% of childhood cancers begin in the brain or spinal cord. There are about 4,100 new cases of CNS tumors in the United States each year. Brain and spinal cord tumors are the leading cause of pediatric cancer deaths.

Of pediatric brain tumors, about half are tumors called gliomas or astrocytomas. They form from glial cells, which make up the supportive tissue of the brain. Gliomas may be benign or malignant and can occur in different areas of the brain and the spinal cord.

The most common malignant brain tumor in children is dulloblastoma. This cancer forms in the cerebellum, in the back area of the brain in a region known as the posterior fossa

Brain Anatomy

The brain is made up of 3 main parts: the cerebrum, the cerebellum, and the brain stem. The meninges, which surround the brain, are also considered part
of the brain.

The cerebrum.

This is the largest part of the brain. It contains 2 cerebral hemispheres on either side of the brain that each control the opposite side of the body. It is divided into 4 lobes where specific functions occur:

The frontal lobe controls reasoning, emotions, problem-solving, expressive speech, and movement
The parietal lobe controls the sensations of touch, such as pressure, pain, and temperature. It also controls parts of speech, visual-spatial orientation, and calculation
The temporal lobe controls memory, special senses such as hearing, and the ability to understand spoken or written words
The occipital lobe controls vision

The cerebellum.

The cerebellum is located at the back part of the brain below the cerebrum. It is responsible for coordination and balance and controls functions on the same side of the body.

The brain stem.

This is the portion of the brain that connects to the spinal cord and the cerebellum. It controls involuntary functions essential for life, such as the beating of the heart and breathing. Messages for the functions controlled by the cerebrum and cerebellum travel through the brain stem to the body.

The Meninges

These are the membranes that surround and protect the brain and spinal cord. There are 3 meningeal layers, called the dura mater, arachnoid, and pia mater. The cerebrospinal fluid (CSF) is made near the center of the brain, in the lateral ventricles. CSF circulates around the brain and spinal cord between the arachnoid and pia layers.

More specifically parts of the brain anatomy:

The Ventricular System

The ventricular system is a set of communicating cavities within the
brain. These structures are responsible for the production, transport
and removal of cerebrospinal fluid, which bathes the central nervous
system.

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Cerebrospinal Fluid is an ultrafiltrate of plasma that surrounds the brain and spinal cord. It serves three main functions: protection, buoyancy & chemical stability.
Ventricles of the Brain are structures that produce cerebrospinal fluid, and transport it around the cranial cavity. They are lined by ependymal cells, which form a structure called the choroid plexus. It is within the choroid plexus that CSF is produced. There are four ventricles; right and left lateral ventricles, third ventricle and fourth ventricle.

The clinical significance:

Increase in intracranial pressure-symptoms

Double vision or other visual changes
Pressure on the optic discs (called papilledema), seen by a physician when looking into eyes with an ophthalmoscope
Headaches (which awaken the child from sleep)
Vomiting (typically in the morning, which often temporarily relieves the nausea and headache)
Unsteady gait
Sleepiness or lethargy
Memory problems

Before Diagnosis:
Presenting Symptoms

Commonly parents notice something is wrong with child or a note is made during a well visit, unfortunately some of the signs and symptoms mimic common childhood illnesses, which can make diagnosis difficult.

Presenting symptoms leading up to a diagnosis, side effects and symptoms during treatment that may affect your protocol and treatment plan & late effects treatment are detailed on this page. We talk about the population most commonly affected and the immediate next steps in getting the best care for your child.

Below are some of the signs that may indicate a need for further investigation.

Presenting Symptoms Upon noticing these symptoms your child should be brought in for further cause investigation. Dependent on severity either your General Practioner or Emergency Room..

Headaches (often with early morning vomiting)
Change in speech
Dizziness
Trouble swallowing
Seizures (convulsions)
Drowsiness
Staring spells
Facial drooping or asymmetry
Loss of peripheral vision
Nausea relieved by vomiting
Double vision
Hormonal or growth problems
Nystagmus (jiggling of an eyeball from side to side)
Hearing loss
Inability to look up
Changes in appetite or thirst
One eye turns inward or outward
Behavior changes
Weakness in hands on one or both sides of the body
Change in school performance
Unsteady gait

These symptoms may be related to the brain tumor itself or be due to the buildup of pressure within the brain. Symptoms are often progressive over weeks and months, and it is not uncommon for patients to have an extended symptomatic period prior to inital diagnosis. Please contact a medical professional to evaluate symptoms or emergency medical care when necessary.

Spinal Cord TumorThe following are signs and symptoms that may indicate the presence of a spinal cord tumor in a child:

Back or neck pain, which may awaken the child from sleep
Scoliosis (curvature of the spine, resulting in leaning of shoulders to one side or a noticeable hump in the back)
Torticollis (tilting of the head and upper spine to one side)
Weakness or sensory changes in arms and legs
Changes in bowel and bladder control

These symptoms can be present for a long or short period of time, depending on the location and growth rate of the tumor. A child with a brain or spinal cord tumor usually has more than one symptom. Please contact a medical professional to evaluate symptoms or emergency medical care when necessary.

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After Treatment
Monitoring + Management

Care for children diagnosed with Medulloblastoma does not end when active treatment has finished. Your child’s health care team will continue to check that the tumor has not come back, manage any side effects, and monitor your child’s overall health. This is called follow-up care. All children treated for medulloblastoma should have life-long, follow-up care. Sometimes, side effects may linger
beyond the active treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Late effects can occur almost anywhere in the body. They include physical problems, such as heart and lung problems and second cancers, which is a new cancer that happens in someone who has had cancer before. They also include emotional problems, such as anxiety, depression, and problems with memory, thinking, attention, and learning difficulties.

Specialty Care & Late Side Effects

Curemedullo Is A Division Of The Carson Leslie Foundation ©2021 All rights reserved. The Carson Leslie Foundation (CLF) is a registered 501(c)(3) charity organization. Please note that cureMEdullo provides this information for the benefit of the medulloblastoma and childhood cancer community. cureMEdullo and CLF are not medical providers or a health care facility and thus can neither diagnose any disease or disorder nor endorse or recommend any specific medical treatments. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder.