There are many different types of brain and spinal tumors and cancers in children. They are categorized based on their location within the central nervous system, the type of cells involved and how fast they grow.

Whether benign or malignant, brain tumors can put pressure on healthy areas of the brain. Since the skull restricts space for the brain, any mass or abnormal growth can be dangerous.

The experienced pediatric neuroscience and cancer specialists with the Norton Children’s Brain & Spinal Tumor Program are at the leading edge of researching and using the latest treatments in children, teens and young adults with all types of tumors affecting the central nervous system.

The Brain & Spinal Tumor Program brings together the skilled physicians of Norton Children’s Neuroscience Institute and Norton Children’s Cancer Institute, both affiliated with the UofL School of Medicine, for each child’s care.

This multidisciplinary team of board-certified physicians evaluates each case with a range of expertise and research-based perspectives. They bring their experiences and viewpoints to each child’s case, discuss courses of treatment and arrive at a customized treatment plan for the patient.

Medical treatment isn’t the only component of successful care. Our specialists and team of providers offer comprehensive support services, including music therapy and neuropsychological services, that treat the whole person — not just the tumor.

Types of Brain and Spinal Tumors in Children

Many types of tumors start or occur in the brain or spinal cord. Brain tumors in children, unlike adults, are more likely to start in the lower part of the brain, such as the cerebellum or brain stem.

A tumor is categorized based on the type of cell it starts from and the grade (slower tumors and those less likely to grow into nearby tissue are considered grade 1 or 2; those that grow quickly and are more likely to grow into nearby tissue are classified as grade 3 or 4).

Some of the more common brain and spinal tumors include:

• Ependymoma – Ependymoma tumors develop in the brain cells that make cerebrospinal fluid and typically develop in children under age 5. Most don’t spread (metastasize) to other areas of the body.
• Glioma – This is the most common type of brain tumor in children. A glioma tumor can grow anywhere in the brain or spine with different symptoms depending on its location. A low-grade glioma is slow-growing, while a high-grade glioma grows fast. A high-grade glioma is more likely to spread and is harder to treat.
• Germ cell tumor – Germ cells are the reproductive cells in an unborn baby. They make sperm in boys and eggs in girls. Unusual germ cell growth can cause tumors in various locations in the body, but typically in the testes or ovaries. Germ cell tumors can develop in the breastplate, spine, middle part of the brain and elsewhere in the body.
• Medulloblastoma – Medulloblastoma is a tumor in the cerebellum. The cerebellum is the part of the brain that controls coordination, balance and complex motor functions. The condition most often occurs in the central part of the cerebellum.
• Neuroblastoma – This type of cancer starts in neuroblasts, which eventually develop into neuron brain cells. If they grow uncontrollably, they become cancer cells that form a solid tumor. Almost all cases of neuroblastoma happen in infants and children under age 5.
• Spinal tumor – Most children with spinal tumors are long-term survivors due to advancements including improved surgical techniques, chemotherapy and radiation

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Common Symptoms of a Brain Tumor in Children

Signs and symptoms of a brain tumor in children can vary based on the location, size, type and rate of growth. Since younger children often cannot properly communicate how they feel, parents must rely on their observations. Some symptoms can come and go.

Common symptoms include:

• Headaches that come more frequently and severely. They may be worse in the morning or when lying down because of increased pressure in the brain.
• Unexplained nausea or vomiting, especially without diarrhea.
• Changes in vision, hearing or speech.
• Sudden or severe mood swings or personality changes.
• Trouble with balance or walking.
• New weakness or numbness in a part of the body, often on just one side of the body.
• Abnormally large head for age, also called macrocephaly.
• Staring spells or seizures.

Tests for Brain and Spinal Cord Tumors in Children

A child experiencing brain tumor symptoms should immediately be seen by a medical provider and thoroughly assessed. Along with a complete medical history and physical examination, diagnosing a brain tumor may include:

• Neurological exam – A physician will test the child’s reflexes, muscle strength, eye and mouth movement, hearing, coordination and alertness.
• CT scan – This test uses a combination of X-rays and computer technology to produce images from different angles that are combined to form a 3D image. A CT scan shows detailed images of any part of the body, including internal organs such as the brain. The CT scan can measure a tumor and, using contrast dye, can provide greater detail.
• MRI – Unlike a CT scan, an MRI uses magnetic fields rather than X-rays to collect detailed images. An MRI provides greater detail than a CT scan and, if suitable for the patient, is preferred for diagnosing a brain tumor.
• fMRI – During a functional MRI (fMRI), the patient will perform specific tasks that will be reflected in the brain. This test helps the surgeon plan surgery so as to avoid damaging healthy, functional parts of the brain while removing a tumor. fMRI can be used in children older than age 4.
• Biopsy – This procedure removes a small piece of tissue for examination and is the only definitive way to diagnose a brain tumor. A biopsy can be performed while removing the tumor or as an intermediate step if surgical removal isn’t possible because of the location or patient’s health.
• Lumbar puncture/spinal tap – A special needle is inserted into the lower back and into the spinal canal around the spinal cord. A small amount of cerebrospinal fluid, which surrounds the brain and spinal cord, can be removed and sent for testing.