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Short-term neurological outcome of children after surgery for brain tumors: incidence and characteristics in a pediatric intensive care unit

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Abstract

Purpose

The main treatment for majority of pediatric brain tumors relies on surgery. In postoperative period, patients require monitoring in a pediatric intensive care unit (PICU). In this study, we analyzed the incidence of postoperative neurological complications and the outcome of neurological impairment in individual patients.

Patients and methods

Our retrospective single-center study concerned all patients who were admitted to the PICU of the University Hospital of Angers between 2002 and 2008, after brain tumor resection. Population, perioperative data, and outcome through the stay in PICU have been analyzed.

Results

We reported 117 neurosurgical procedures. Majority of children (85.3%) were affected by neurological deficit before surgery: cranial nerve palsy and cerebellar syndrome were the most frequent impairment. In the first 2 days, neurological symptoms improved for 27 patients (23.7%), especially in children with preoperative cerebellar syndrome, convulsions, or endocrine disorders. Mean length of stay in PICU was correlated with the severity of neurological impairment (p = 0.006). Five children presented a transient mutism after surgery for infratentorial tumors (n = 5/54, 9.2%). Eight spontaneous cerebral spinal fluid leaks occurred precociously after surgery, and neurological infections complicated half of them. Neurological infections occurred in 12 patients (ten meningitis, one ventriculitis, and one brain abscess). One patient died after surgery.

Conclusions

All these complications and their risk factors have to be systematically searched for in order to decrease postoperative morbidity of brain tumors in children. They justify neurosurgeons and anesthesiologists specialized in these pathologies.

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References

  1. Desandes E, Lacour B, Sommelet D, Buemi A, Danzon A, Delafosse P, Grosclaude P, Mace-Lesech J, Raverdy-Bourdon N, Tretarre B, Velten M, Brugieres L (2004) Cancer incidence among adolescents in France. Pediatr Blood Cancer 43:742

    Article  PubMed  Google Scholar 

  2. Desandes E, Clavel J, Berger C, Bernard JL, Blouin P, de Lumley L, Demeocq F, Freycon F, Gembara P, Goubin A, Le Gall E, Pillon P, Sommelet D, Tron I, Lacour B (2004) Cancer incidence among children in France, 1990–1999. Pediatr Blood Cancer 43:749

    Article  PubMed  Google Scholar 

  3. Meyer P, Orliaguet G, Blanot S, Cuttaree H, Jarreau MM, Charron B, Carli P (2002) Anesthesia-resuscitation for intracranial expansive processes in children. Ann Fr Anesth Rèanim 21:90

    PubMed  CAS  Google Scholar 

  4. Morelli D, Pirotte B, Lubansu A, Detemmerman D, Aeby A, Fricx C, Berre J, David P, Brotchi J (2005) Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified? J Neurosurg 103:247

    PubMed  Google Scholar 

  5. Abdullah S, Qaddoumi I, Bouffet E (2008) Advances in the management of pediatric central nervous system tumors. Ann NY Acad Sci 1138:22

    Article  PubMed  CAS  Google Scholar 

  6. Nejat F, El Khashab M, Rutka JT (2008) Initial management of childhood brain tumors: neurosurgical considerations. J Child Neurol 23:1136

    Article  PubMed  Google Scholar 

  7. Chang SM, Parney IF, McDermott M, Barker FG 2nd, Schmidt MH, Huang W, Laws ER Jr, Lillehei KO, Bernstein M, Brem H, Sloan AE, Berger M (2003) Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project. J Neurosurg 98:1175

    Article  PubMed  Google Scholar 

  8. Pollack IF (1994) Brain tumors in children. N Engl J Med 331:1500

    Article  PubMed  CAS  Google Scholar 

  9. Kaderali Z, Lamberti-Pasculli M, Rutka JT (2009) The changing epidemiology of paediatric brain tumours: a review from the Hospital for Sick Children. Childs Nerv Syst 25:787

    Article  PubMed  Google Scholar 

  10. Bauchet L, Rigau V, Mathieu-Daude H, Fabbro-Peray P, Palenzuela G, Figarella-Branger D, Moritz J, Puget S, Bauchet F, Pallusseau L, Duffau H, Coubes P, Tretarre B, Labrousse F, Dhellemmes P (2009) Clinical epidemiology for childhood primary central nervous system tumors. J Neurooncol 92:87

    Article  PubMed  Google Scholar 

  11. Sainte-Rose C, Cinalli G, Roux FE, Maixner R, Chumas PD, Mansour M, Carpentier A, Bourgeois M, Zerah M, Pierre-Kahn A, Renier D (2001) Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg 95:791

    Article  PubMed  CAS  Google Scholar 

  12. Russell SM, Elliott R, Forshaw D, Kelly PJ, Golfinos JG (2005) Resection of parietal lobe gliomas: incidence and evolution of neurological deficits in 28 consecutive patients correlated to the location and morphological characteristics of the tumor. J Neurosurg 103:1010

    Article  PubMed  Google Scholar 

  13. Rekate HL, Grubb RL, Aram DM, Hahn JF, Ratcheson RA (1985) Muteness of cerebellar origin. Arch Neurol 42:697

    PubMed  CAS  Google Scholar 

  14. Siffert J, Poussaint TY, Goumnerova LC, Scott RM, LaValley B, Tarbell NJ, Pomeroy SL (2000) Neurological dysfunction associated with postoperative cerebellar mutism. J Neurooncol 48:75

    Article  PubMed  CAS  Google Scholar 

  15. Rath GP, Bithal PK, Chaturvedi A, Dash HH (2007) Complications related to positioning in posterior fossa craniectomy. J Clin Neurosci 14:520

    Article  PubMed  CAS  Google Scholar 

  16. Dailey AT, McKhann GM 2nd, Berger MS (1995) The pathophysiology of oral pharyngeal apraxia and mutism following posterior fossa tumor resection in children. J Neurosurg 83:467

    Article  PubMed  CAS  Google Scholar 

  17. Kotil K, Eras M, Akcetin M, Bilge T (2008) Cerebellar mutism following posterior fossa tumor resection in children. Turk Neurosurg 18:89

    PubMed  Google Scholar 

  18. Dubey A, Sung WS, Shaya M, Patwardhan R, Willis B, Smith D, Nanda A (2009) Complications of posterior cranial fossa surgery—an institutional experience of 500 patients. Surg Neurol 72:369

    Article  PubMed  Google Scholar 

  19. Kalfas IH, Little JR (1988) Postoperative hemorrhage: a survey of 4992 intracranial procedures. Neurosurgery 23:343

    Article  PubMed  CAS  Google Scholar 

  20. Palmer JD, Sparrow OC, Iannotti F (1994) Postoperative hematoma: a 5-year survey and identification of avoidable risk factors. Neurosurgery 35:1061

    Article  PubMed  CAS  Google Scholar 

  21. Dashti SR, Baharvahdat H, Spetzler RF, Sauvageau E, Chang SW, Stiefel MF, Park MS, Bambakidis NC (2008) Operative intracranial infection following craniotomy. Neurosurg Focus 24:E10

    Article  PubMed  Google Scholar 

  22. Korinek AM (1997) Risk factors for neurosurgical site infections after craniotomy: a prospective multicenter study of 2944 patients. The French Study Group of Neurosurgical Infections, the SEHP, and the C-CLIN Paris-Nord. Service Epidemiologie Hygiene et Prevention. Neurosurgery 41:1073

    Article  PubMed  CAS  Google Scholar 

  23. Korinek AM, Baugnon T, Golmard JL, van Effenterre R, Coriat P, Puybasset L (2006) Risk factors for adult nosocomial meningitis after craniotomy: role of antibiotic prophylaxis. Neurosurgery 59:126

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Oncology, Centre Hospitalier Universitaire d’Angers, 4, rue Larrey, 49933, Angers, France

    Stéphanie Proust Houdemont, Emilie De Carli & Xavier Rialland

  2. Department of Neurosurgery, Centre Hospitalier Universitaire d’Angers, 4, rue Larrey, 49933, Angers, France

    Matthieu Delion & Philippe Mercier

  3. Department of Pediatric Intensive Care, Centre Hospitalier Universitaire d’Angers, 4, rue Larrey, 49933, Angers, France

    Benedicte Ringuier, Catherine Chapotte, Catherine Jeudy & Jean-Claude Granry

Authors
  1. Stéphanie Proust Houdemont
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  2. Emilie De Carli
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  3. Matthieu Delion
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  4. Benedicte Ringuier
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  5. Catherine Chapotte
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  6. Catherine Jeudy
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  7. Philippe Mercier
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  8. Jean-Claude Granry
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  9. Xavier Rialland
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Correspondence to Stéphanie Proust Houdemont.

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Proust Houdemont, S., De Carli, E., Delion, M. et al. Short-term neurological outcome of children after surgery for brain tumors: incidence and characteristics in a pediatric intensive care unit. Childs Nerv Syst 27, 933–941 (2011). https://doi.org/10.1007/s00381-010-1373-x

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  • DOI: https://doi.org/10.1007/s00381-010-1373-x

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