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Childhood Visual Pathway Glioma

Treatment for Childhood Visual Pathway Glioma :

Childhood Visual Pathway Glioma is a kind of brain tumor where the malignant cancer cells start growing in the tissues of the brain. Few of the controls that the brain handles are memory and learning, emotions, senses of hearing, sight, smell, taste and touch. It also controls other parts of the body, including muscles, organs, and blood vessels.

Diagnosis

Like most cancer, childhood brain tumor is best treated when it is found (diagnosed) early. Based on the symptoms, a Computed Tomographic (CT) scan of your child's brain may be required. A Magnetic Resonance Imaging (MRI) scan, which uses magnetic waves to make a picture of your child's brain, also may be done.

In most cases, surgery may be required to see if there is a brain tumor and to assess the kind of tumor it is. A biopsy may be done, where the doctor cuts out a piece of tissue from the brain and examines it under a microscope.There are many types of brain tumors in children and the chance of recovery (prognosis) depends on the type of tumor, where it is located within the brain and the child's age and general health.There are treatments for all children with visual pathway gliomas.

Symptoms

The most common symptom noticed is a visible or palpable mass. Congenital lesions may be found at the time of birth by either the examining doctor or the parents. Swelling of the scalp related to birth may obscure a congenital lesion or cephalohematoma which would later show up. Infants with high-flow vascular malformations may have signs of high output heart failure which includes failing to thrive or cardiac murmurs.

Procedures

Children with a scalp or skull tumor are usually recommended a surgery to decompress the neural structures, curative or palliative resection, correction of deformities, relief of pain and to do a biopsy of an unknown lesion. All procedures have to be planned in anticipation of a reconstructive procedure.

In a lot of cases, the defect left by the resection of a skull tumor may be fixed with a split thickness bone graft taken from the adjacent cranium. The scalp incision should be designed in such a way so as to allow maximum vasculanty as well as comfortable access to the potential donor site. In spite of its length the standard coronal scalp incision is usually the best choice. In cases where there is poor wound or graft healing, the reconstruction is delayed until the healing conditions are optimized. This helps avoid the loss of both the donor and recipient graft. Such cases usually occur when there is radiation or chemotherapy indicated to the patient.

Most scalp or skull tumors do not demonstrate intradural extension. Congeneital lesions though, frequently have a definite connection to the underlying brain which has to be appreciated. Failure to completely excise a dermal tract can allow growth of an intracranial dermoid cyst or result in a delayed infection. Apart from these, adhesion of the brain to overlying dura has been found to cause neurological symptoms that are similar to spinal cord “Tethering”. Hence, very serious consideration should be given to intradural exploration when transdural extension is apparent.

The various procedures adopted are:

  • Surgery (Removing the cancerous tissue through an operation)
  • Radiation Therapy (using high-dose X-Rays to kill cancer cells)
  • Chemotherapy (Oral or IV drugs to kill cancer cells)

The treatment will often be coordinated by a pediatric oncologist, a pediatric neurosurgeon (a specialist in childhood brain surgery), a pediatric neurologist, a psychologist, a radiation oncologist and other doctors who specialize in the type of treatment the child requires.

Surgery is one treatment for visual pathway glioma. Depending on where the cancer is and the type of cancer, your child's doctor may remove as much of the tumor as possible. If the tumor cannot be totally removed, radiation therapy and chemotherapy may also be given. If the cancer is in a place where it cannot be removed, then surgery may be limited to a biopsy of the cancer.

Radiation therapy (external radiation therapy) uses high-energy X-Rays to kill cancer cells and shrink tumors. The use of radiation put into the brain through thin plastic tubes (internal radiation therapy) is under study. For some types of brain tumors, clinical trials are evaluating radiation therapy given in several small doses per day (hyperfractionated radiation therapy). Radiation therapy can affect growth and brain development, so clinical trials are testing ways to decrease or delay radiation therapy, especially for younger children.

Chemotherapy is a process where drugs are utilized to kill cancer cells. It may be taken by a pill or could be injected with a needle in a vein or muscle in your body. Chemotherapy is known as a “Systemic Treatment” because the drug that is administered enters the bloodstream and can kill cancer cells present anywhere in the body.

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