Neuroophthalmic Manifestations of Intracranial Tumours in Children

Abstract

Background. All children between 0 and 16 years presenting with brain tumours confirmed by Magnetic Resonance Imaging (MRI) and treated surgically in our institute were included in this study. Objective. The aim of this study is to evaluate the neuroophthalmic and clinical characteristics of intracranial space occupying lesions in children. Methods. Neuroophthalmic manifestations along with location of the tumour by contrast-enhanced MRI, type of surgical intervention, and postoperative histopathological diagnosis were evaluated. Results. In pediatric brain tumours, male preponderance was seen and supratentorial location was more common in general, while in older children, infratentorial tumours were more common than supratentorial tumours. Headache, vomiting, and cerebellar signs were the commonest neurological features. Diminution of vision, diplopia, and strabismus were the commonest ophthalmic symptoms. Papilledema, ophthalmoparesis, and nystagmus were the most frequent ophthalmological signs. Neurological manifestations of seizures, altered sensorium and motor deficits were more frequently seen in supratentorial tumours, while cranial nerve involvement and ataxia were seen in infratentorial tumours. Ophthalmological manifestations including diplopia, strabismus, ophthalmoparesis, and nystagmus were more frequently seen in infratentorial tumours. Astrocytoma was the most frequent histopathological diagnosis followed by medulloblastoma. Conclusion. Diagnosis of pediatric intracranial tumours is complex and requires a multidisciplinary approach for prompt management. An ophthalmologist should have a high index of suspicion for brain tumours especially in patients presenting with common ocular symptoms like diminution of vision, diplopia, and strabismus without any neurological symptoms.

Neuro-ophthalmic manifestations of intracranial space occupying lesions in adults

“…Contrast-enhanced MRI is the investigation of choice which was done in all our cases. In addition, MRI angiogram and venogram to display vasculature alongside the tumor, MR spectroscopy to assess the metabolic activity of the tumor, and functional MRI with tactography to provide additional information on the course of important white matter tracts and their relationship with the tumor were done depending on the type and location of the tumor before planning surgical intervention ( 15 , 29 ).…”

Detection of visual field defects using Eye Movement Pediatric Perimetry in children with intracranial lesions: feasibility and applicability

“…Hence perimetry turns out to be an integral component in the ophthalmological management protocol to evaluate the stability or progression of the causative lesion. Perimetry not only contributes to clinical management decisions but also offers essential assistance while rehabilitating these children [ 1 , 2 ].…”