Supratentorial glioma-clinicopathological study of 105 cases

Abstract

One hundred and five children below the age of 15 years treated for supratentorial gliomas over a 20 year period 1966 through 1985 were analysed. They constituted 28·3% of all gliomas and 15% of all surgically verified tumours in children. Sixty-eight (65%), tumours were located in the cerebral hemisphere and 37 (35%) were in the midline. Two third patients with midline tumour were below 10 years of age, while in hemispheric gliomas only 40% children were under 10 years of age. About a third of the hemispheric gliomas were malignant compared to 14% in the midline group. Glioblastoma multiforme was only encountered in the cerebral hemisphere and constituted 12% of all hemispheric gliomas. Early raised intracranial pressure, cerebellar signs and altered sensorium were the common findings among the children with midline gliomas. Children with hemispheric gliomas more often presented with convulsions and hemiparesis. Radical excision was undertaken whenever it was possible (88 patients). Stereotactic biopsy was performed in 12 children with midline gliomas. All the patients were subjected to radiotherapy for 3-4 weeks, following surgery. Overall post-operative mortality was 7·5%. Mortality was lower in children with hemispheric gliomas than midline ones (4·5% vs 13·5%).