소아의 뇌종양에 관한 임상적 관찰

Abstract

[한글]

[영문]

The clinical studies were made on 85 cases of brain tumor (including to 10 cases of cerebral paragonimasis) occurring under the age of 16 years, observed at Severance Hospital, Yonsei University, during a period of 14 years, from Jan. 1, 1956 to Dec. 31, 1970.

During this period there were 9,238 admission to the Departments of Pediatrics and Neurosurgery of Severance Hospital, Yonsei University.

Our group comprises 85 cases giving a ratio of 0.92 per cent.

Data were analysed by sex, age, anatomical distribution, and pathologic findings of all brain tumors under 16 years of age, and symptoms and X-ray changes of supratentorial and infratentorial tumors respectively.

The following results were obtained:

1. 85 tumors divided into 50 verified and 35 unverified but probable tumors.

2. The age distribution among these 85 tumors showed the highest frequency in the age of 7-8 (27.1%).

3. The sex ratio of male and female was approximately 1.7:1 for all the tumors; 7:3 in the verified and 1:1 in the unverified but probable tumors.

4. The verified tumors were supratentorial in 28 patients (56%) and infratentorial in 22 patients(44%), and the most common histologic type was glioma (56%).

5. Among the 50 verified tumors astrocytoma was the commonest neoplasam being present in 12 cases or 24%, and cerebral paragonomiasis 10 cases (20%), medulloblastoma 7 cases 914%), ependymoma 4 cases (8%), craniopharyngioma 3 cases

(6%), hemangioma 3 cases (6%), brain stem glioma 2 cases (4%), pituitary adenoma 2 cases (4%), cholesteatoma 1 case (2%), oligodendroglioma 1 case (2%) and pinealoma 1 case (2%) in givenorder of frequency.

6. The incidence of headache was 75.0% and was most frequently seen in cases of supratentorial tumors. Other symptoms were vomiting (57.1%), papilledema (35.7%), motor weakness (35.7%), cervical rigidity(25.0%), visual disturbance (25.0%), convulsions (25.0%), and staggering gait (17.9%).

In infratentorial tumors, vomiting was the most common symptom (81.8%) and others were headache (72.7%), papilledema (54.5%), stagering gait (54.5%), cervical rigidity (36.4%), ataxia (31.8%) motor weakness (22.7%), decreased visual acuity (22.7%), abdominal pain (13.6%), enlarged head (13.6%), squint (9.1%), and

convulsions (9.1%). Average duration of symptoms at the time of the first admission was 10.7 months in the supratentorial and 3.3 months in the infratentorial tumors.

7. Skull X-ray changes were noted in 33 of the 42 available cases (78.6%). Calcified changes (52.0%) wer noted in 13 cases (10 cerebral paragonimiasis and 3 cranipharyngiomas) of 25 available cases in supratentorial tumors. There was separation of the suture line (53.0%), increased convolutional markings(47.0%), and alteration in the sella (24.0%) in infratentorial tumors.