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Maria L. Salvetat, Chiara Stocco, Marco Zeppieri, Flavia Miani, Eva Passone, Mirella Felletti, Chiara Pilotto, Paolo Brusini; Visual Signs And Symptoms Of Brain Tumours In Children. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6764.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the frequency and type of visual signs and/or symptoms in a pediatric population affected by brain tumours.
This retrospective, observational case study included 67 children, 42 males and 25 females, aging between 5 months to 16.5 years (mean age of 7.8±5 years), with a brain tumour diagnosed between January 2000 and August 2011. Supratentorial brain tumours were found in 53.7% of cases; glioma was found to be the most frequent histological type (55.2%). Sixty-two of the 67 children (92.5%) underwent neurosurgery (11 of which underwent multiple surgical treatments for recidivant tumour); additional radiotherapy and chemotherapy were required in 18 (26.9%) and 16 (23.9%) cases, respectively.
The most commonly observed signs and/or symptoms at diagnosis were: nausea and vomiting (49.2%), headache (47.8%), visual system abnormalities (47.8%), unsteadiness (34.3%), behavioral or educational problems (31.3%), seizures (25.4%), endocrine or growth abnormalities (7.5%), and macrocephaly (7.5%). The median pre-diagnosis symptomatic interval was 7.5 weeks (ranging from 1 day to 368 weeks). The visual system abnormalities present at the diagnosis included: diplopia and/or squint (34.3%), abnormal eye movements (nystagmus, Parinaud’s syndrome, setting-sun sign) (16.4%), reduced visual acuity and/or blurred vision (11.9%), optic nerve atrophy (10.4%), visual field defects (8.9%), papilloedema (6%), anisocoria and/or photomotor reflex alterations (4.5%), ptosis (6%), primitive visual hallucinations (flashing lights) (3%), photophobia (1.5%) and absence of stereopsis (1.5%). Visual abnormalities were found to be the first isolated clinical symptom at onset in 7.5% of patients; these developed after neurosurgery in 4.5% of cases.
Children with brain tumors developed visual symptoms and/or signs in 52.2% of the cases. The identification of specific visual abnormalities in children can aid in early diagnosis of brain tumors, which can guide in the therapeutic decision making process upon onset to enhance the life quality in these oncologic children.
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