Glioma in Children

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Glioma is the most common type of brain tumor in children. Glioma tumors can happen anywhere in the brain or spine, and symptoms depend on the location of the tumor. The two main classifications are low-grade glioma (slow growing) and high-grade glioma (fast-growing).

Glioma starts in the glial cells, which provide support to neurons so they can do their job. Glial cells in the central nervous system include astrocytes, oligodendrocytes, microglia, ependymal cells and radial glia. Specific types of tumors can develop in these specialized glial cells, including ependymoma and astrocytoma. One subtype of astrocytoma is glioblastoma multiforme.

The cause of glioma isn’t known, but the tumor is more likely to develop in children with some types of genetic conditions.

The physicians with the Norton Children’s Brain & Spinal Tumor Program can treat many types of glioma with surgery alone. However, some tumors require combinations of surgery, chemotherapy and radiation therapy.

The five-year survival rate for glioma varies broadly based on type. Children with pilocytic astrocytoma, a slow-growing and benign glioma, live at least five years after diagnosis 95% of the time, according to the American Cancer Society. Glioblastoma, on the other hand, has a 20% five-year survival rate. Many go on to live longer and many are cured, meaning no traces of cancer remain.

The neuroscience and oncology specialists with the Norton Children’s Brain & Spinal Tumor Program are working to improve life expectancy for kids with brain tumors. They stay at the forefront of research into new treatments, conduct clinical trials of new drugs and therapies, and publish their findings in prestigious medical journals so others can benefit from their discoveries.

Anthony Brettnacher Thrives After Complex Multidisciplinary Care for Glioma and Stroke

The Brain & Spinal Tumor Program is a collaboration of Norton Children’s Neuroscience Institute and Norton Children’s Cancer Institute, both affiliated with the UofL School of Medicine. Bringing together specialists with different viewpoints, experiences and training means patients benefit from multiple opinions and get customized treatment plans.

Types of Gliomas

  • Pilocytic astrocytomas – The most common type of glioma forms from star-shaped brain cells called astrocytes. These tumors are slow-growing and often can be removed with surgery. They occur most often in the cerebellum. If they can’t be removed surgically, chemotherapy or radiation therapy often is successful. Other slow-growing gliomas include tectal glioma, oligodendroglioma, ganglioglioma and pleomorphic xanthoastrocytoma.
  • Optic nerve gliomas form in or around the optic nerve that connects the eye to the brain.
  • Anaplastic astrocytomas, glioblastoma multiforme and diffuse midline gliomas. These are fast-growing, or high-grade, gliomas and can spread rapidly. These are much harder to treat and are more likely to grow back after treatment.

Glioma Symptoms in Children

A glioma can cause symptoms by pressing on nearby structures in the brain or spinal cord. It also can lead to hydrocephalus, a buildup of spinal fluid and pressure.

Symptoms of glioma vary depending on a child’s age and the tumor’s location. They may include:

  • Headaches
  • Vision issues
  • Vomiting
  • Seizures
  • Weakness of the face, arms or legs
  • Poor coordination, or trouble standing or walking
  • Slurred speech or confusion
  • Changes in behavior
  • Head tilt
  • Increased head size in babies and young toddlers

Glioma Diagnosis and Treatment

If doctors suspect a glioma, they will do an exam and order imaging tests of the brain, such as MRI, which provides images of the inside of the brain and can show any abnormal areas.

If glioma is found, surgery may be the next step. Depending on how the tumor looks on imaging tests, surgeons may try to remove as much of it as they can.

Some low-grade tumors can be treated with surgery alone. Others need a combination of surgery, radiation therapy and chemotherapy. Diffuse midline tumors usually can’t be removed, so kids may get chemotherapy and radiation instead.

Samples of the tumor are viewed under a microscope to confirm what type of tumor it is and whether it is low-grade or high-grade.

At Norton Children’s Brain & Spinal Tumor Program, a board of specialists convenes to review each child’s case. Pathologists, neurosurgeons, oncologists and other specialists go over images, lab results and other data. They offer their opinions on treatment based on their varied backgrounds, experience and expertise. The result is not just a second opinion, but a third and often a fourth that helps develop a customized treatment plan for each child. Norton Children’s Cancer Institute is a long-standing member of the Children’s Oncology Group. The Children’s Oncology Group is the largest group of hospitals around the world that treat children with cancer. Our involvement means patients have access to innovative new treatments through clinical trials.

Current Glioma Clinical Trials and Studies Through Norton Children’s Brain & Spinal Tumor Program

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