Clinical aspects and long-term prognosis of infratentorial intracranial tumours in infancy and childhood

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Abstract
An unselected series of 185 children with intracranial tumors in the posterior fossa, aged from birth up to and including 14 yr, was followed from 1-40 yr after diagnosis. Follow-up was 100%. There were 102 boys and 83 girls, i.e., a male/female ratio of 1.22. The same sex ratio was found in all tumor localizations and in most of the histological groups, with the exception of ependymoma, where it was 2.0. All children with tumors in the 4th ventricle or the cerebellar hemispheres had signs of increased intracranial pressure on admission to hospital, and the duration of these symptoms was less than 6 mo. in 77% of the children. Patients [113] survived for more than 1 mo. after surgery or diagnosis, and 46 (41%) for at least 15 yr. All 34 children with tumors in the brain stem died within the first 2 yr of observation, apart from 3 who survived 4, 5 and 10 yr. All but 1 of the children with medulloblastoma and all but 2 with ependymona died within 1-17 yr. Five children with astrocytoma suffered tumor recurrence more than 10 yr after primary surgery. One with astrocytoma in the 4th ventricle and 36 with cerebellar astrocytoma survived for at least 15 yr. In the survivors the tumor was located in the 4th ventricle in 3, the cerebellopontine angle in 1 and the vermis or cerebellar hemispheres in 42. Forty-one of these 46 survivors led a normal life.