Brain tumors (also see brain tumors in adults Overview of Brain Tumors A brain tumor can be a noncancerous (benign) or cancerous (malignant) growth in the brain. It may originate in the brain or have spread (metastasized) to the brain from another part of the body... read more ) are the second most common cancer in children Overview of Childhood Cancer Cancer is rare among children. In 2021 in the United States, an estimated 10,500 children aged birth to 14 years will be diagnosed with cancer and slightly over 1,100 children will die of it... read more younger than 15 years of age (after leukemia) and the second leading cause of death from cancer.
The most common brain tumors in children are astrocytomas Astrocytomas Astrocytomas are brain and spinal cord tumors that develop from star-shaped cells (astrocytes) that help nerve cells in the brain (or spinal cord) function. These tumors may be cancerous or... read more . Less common brain tumors include medulloblastomas Medulloblastomas Medulloblastomas are rapidly growing brain tumors that develop in the cerebellum (the part of the brain that helps control coordination and balance). The cause of medulloblastomas is not known... read more
and ependymomas Ependymomas Ependymomas are slow-growing brain tumors that develop from cells lining the spaces within the brain (ventricles). The cause of ependymomas is not known. Some symptoms are vomiting, listlessness... read more .Brain tumors can cause various symptoms, including headaches, nausea, vomiting, vision problems, listlessness, and loss of coordination or balance.
The diagnosis is usually based on results of magnetic resonance imaging and a biopsy.
Treatment may involve surgery, radiation therapy, chemotherapy, or a combination.
The cause of most brain tumors is usually unknown. However, high doses of radiation Radiation and cancer Radiation injury is damage to tissues caused by exposure to ionizing radiation. Large doses of ionizing radiation can cause acute illness by reducing the production of blood cells and damaging... read more and certain genetic disorders (for example, neurofibromatosis Neurofibromatosis Neurofibromatosis is a group of genetic disorders in which many soft, fleshy growths of nerve tissue (neurofibromas) form under the skin and in other parts of the body, and flat spots that are... read more 
) are known to cause brain tumors.
Symptoms of Brain Tumors in Children
The first brain tumor symptoms may result from increased pressure within the skull (intracranial pressure). Pressure may be increased because the tumor blocks the flow of cerebrospinal fluid within the brain or because the tumor takes up space. Increased pressure can cause the following:
Headaches
Nausea and vomiting (often when the child first awakens)
Vision problems, such as double vision
Difficulty turning the eyes upward
Changes in behavior or consciousness level, making the child irritable, listless, confused, or drowsy
Other symptoms vary depending on the specific part of the brain in which the tumor is located.
Diagnosis of Brain Tumors in Children
Imaging tests
Usually biopsy or sometimes surgery to remove the entire tumor
Sometimes a spinal tap
Doctors suspect a brain tumor based on symptoms.
To check for a brain tumor, doctors typically do an imaging test such as magnetic resonance imaging Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more 
(MRI), which can usually detect the tumor. Computed tomography Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more 
(CT) also can be done. Before MRI or CT is done, a contrast agent is usually injected into a vein (intravenously). Contrast agents are substances that make the images clearer. If a brain tumor is suspected, doctors usually remove a small piece of tissue (biopsy) to confirm the diagnosis. Sometimes, instead of removing a small piece, doctors surgically remove the entire tumor.
Sometimes a spinal tap (lumbar puncture How a Spinal Tap Is Done Low-pressure headaches result when cerebrospinal fluid is removed during a spinal tap (lumbar puncture) or leaks out because of a cyst or tear in one of the layers of tissues that cover the... read more ) is done to obtain cerebrospinal fluid for examination under a microscope. This procedure is done routinely to determine whether tumor cells have spread to the cerebrospinal fluid or when the diagnosis is unclear.
Treatment of Brain Tumors in Children
Surgical removal of the tumor
Chemotherapy, radiation therapy, or both
Drainage of cerebrospinal fluid
(See also Cancer Treatment Principles Cancer Treatment Principles Treating cancer is one of the most complex aspects of medical care. It involves a team that encompasses many types of doctors working together (for example, primary care doctors, gynecologists... read more .)
Usually, treatment of brain tumors involves surgically removing the tumor Surgery for Cancer Surgery is a traditional form of cancer treatment. It is the most effective in eliminating most types of cancer before it has spread to lymph nodes or distant sites (metastasized). Surgery may... read more . Then, chemotherapy Chemotherapy Chemotherapy involves the use of drugs to destroy cancer cells. Although an ideal drug would destroy cancer cells without harming normal cells, most drugs are not that selective. Instead, drugs... read more , radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more , or both Combination Cancer Therapy Cancer drugs are most effective when given in combination. The rationale for combination therapy is to use drugs that work by different mechanisms, thereby decreasing the likelihood that resistant... read more are used. Treatment should be planned by a team of experts Care team for cancer treatment Cancer is rare among children. In 2021 in the United States, an estimated 10,500 children aged birth to 14 years will be diagnosed with cancer and slightly over 1,100 children will die of it... read more who have experience treating brain tumors in children. The care team may include doctors who specialize in the care and treatment of babies, children, and adolescents such as pediatric cancer specialists (oncologists), pediatric neurologists, pediatric neurosurgeons, and radiation oncologists.
When possible, the tumor is removed surgically by opening the skull (called a craniotomy). Some brain tumors can be removed with little or no damage to the brain. After surgery, MRI may be done to determine whether any of the tumor is left and, if so, how much.
If the tumor cannot be removed surgically, additional treatment is usually required. In children younger than 5 to 10 years, depending on the tumor type, chemotherapy may be used first because radiation therapy can interfere with growth and brain development. If needed, radiation therapy may be used when children are older. Chemotherapy may also have serious side effects.
If the tumor is blocking the flow of cerebrospinal fluid, a small tube (catheter) may be used to drain the cerebrospinal fluid before the tumor is surgically removed. After a local or general anesthetic is used, the tube is inserted through a tiny opening drilled in the skull, and fluid is withdrawn to reduce the pressure within the skull. The tube is connected to a gauge that measures the pressure within the skull. After a few days, the tube is removed or converted to a permanent drain (shunt—see Hydrocephalus Hydrocephalus Hydrocephalus is an accumulation of extra fluid in the normal spaces within the brain (ventricles) and/or between the inner and middle layers of tissues that cover the brain (the subarachnoid... read more 
).
Because cancer is relatively rare in children, entry into a clinical trial The Science of Medicine Doctors have been treating people for many thousands of years. The earliest written description of medical treatment is from ancient Egypt and is over 3,500 years old. Even before that, healers... read more , if available, should be considered for all children with a brain tumor. In such trials, some children receive the standard treatment, and others receive the treatment being tested (called experimental treatment). The experimental treatment may involve new drugs, drugs used in new ways, or new surgical or radiation techniques. However, experimental treatments are not always effective, and side effects or complications may not be known.
More Information
The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
American Cancer Society: If Your Child Is Diagnosed With Cancer: A resource for parents and loved ones of a child who has cancer that provides information about how to cope with some of the problems and questions that come up just after a child is diagnosed
The brain tumors organizations here provide information about types of and treatments for brain tumors as well as information for caregivers about support resources:
