Headaches Can Be A Warning Sign Of A Brain Tumour Among Children

Children complaining of headaches is quite common. Children often complain of aches and pains in their heads or in their neck region, respectively. Dehydration, allergies, infections such as the flu, issues relating to eyesight, or because they suffer from undernourishment could trigger them. Children are often unable to accurately describe the pain and may throw up, but get restless, or appear pale when they have them though the headaches may last a few minutes or a few hours. However, if the headaches persist and the symptoms turn more severe with time, it could indicate chances of a paediatric brain tumour.

Paediatric brain tumours

Paediatric brain tumours are masses or growths of abnormal cells that develop in a child's brain or the tissue and the structures around it. Brain tumours among children occur due to defects in the genes that are involved in the cell cycle control, thus resulting in the uncontrolled multiplication of cells. It is most commonly seen in children between the ages of 4 and 9 years.

A common brain tumour that develops in children is the gliomas that develop from the glial cells which make up the brain's supporting tissue. Several kinds of paediatric brain tumours exist, including the Primitive neuroectodermal tumours (PNET) that can occur anywhere in a child's brain, Medulloblastomas that occur around the midline of the cerebellum, the Craniopharyngiomas or benign tumours that develop around the base of the brain and Pineal region tumours that develop around the pineal gland, amongst many others. Some of these are noncancerous (benign) and some are cancerous (malignant).

Symptoms

There are great variations in signs and symptoms of brain tumours in children. They depend on the type, size, location, and rate of growth. Some signs and symptoms may be difficult to identify because they are like many other conditions. Some of the common symptoms include headaches, which may progressively grow more frequent and severe in future; unexplained nausea or vomiting with a feeling of increased pressure in the head; and the sudden onset of issues relating to the eye, including double vision.

Among other possible signs and symptoms, depending on the location of the tumour include a fuller spot on the skull of babies, seizures, abnormal eye movements, slurred speech, a loss of appetite, difficulty in walking and weakness or drooping of the face on one side.

Causes

Patients with certain specific hereditary diseases like neurofibromatosis, or retinoblastoma are more likely to develop central nervous system tumours. There are examples of children in the same family developing brain tumours despite the absence of any hereditary disorders. Some substances have the potential to alter the structure of a gene that protects the body from sickness and cancer. Researchers have been looking at the parents of children with brain tumours and their previous exposure to substances including pesticides and petroleum products. Children who have previously received radiation therapy to the head as part of the treatment for other malignancies are also at a higher risk of developing new brain tumours.

Diagnosis

If a brain tumour is suspected in your child, several tests and procedures will be suggested to aid in the diagnosis and also help establish treatment options. These include neurological exams, imaging tests including MRI scans, biopsy, and precision medicine diagnosis.

Treatment

The first step in the treatment of brain tumours is usually surgery. The goal is to remove as much of the tumour as feasible while keeping the normal neurological functions.

To kill the tumour cells, radiation therapy is used that employs high-energy beams such as X-rays or protons. Radiation therapy can be delivered from a machine outside the body which is called external beam radiation. Steroids to treat or prevent swelling, especially in the brain, along with the use of anti-seizure medications. A ventriculoperitoneal shunt, also called VP shunt, may be placed in the head to drain the excess fluid from inside the skill to the abdomen. 

It is important to monitor the neurological functions of the child post-surgery. Regular follow-up visits to evaluate the overall health condition and analyse the side effects are crucial to safeguard the child against any possibilities of recurrence of the tumour. 

Treatment for brain tumours among children is typically quite different from the treatment for adult brain tumours. Hence, it must be kept in mind that owing to the location of the tumour, certain types of brain tumours in children can cause long-term impairments to their cognitive and neurological functions. It is, therefore, always best to see a physician if your child shows any signs or symptoms that are a cause for worry and it's very important to enlist the expertise and experience of paediatric specialists in neurology and cancer.

(Dr. Prakash Bhagat, Surgical Oncologist, HCG Cancer Hospital, Ranchi)

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