Clinical Pattern and Imaging Findings of Intracranial Space Occupying Lesions in Children

Abstract

A cross sectional and prospective hospital based study in Elshaab Teaching Hospital (National Center For Neurological Science), Khartoum Teaching Hospital and Dr Gafaar Ibn Auf Children's hospital. The duration of the study was from 1st of September 2005 to the end of February 2007. The objectives were to study the clinical presentations, causes and the imaging findings associated with the intracranial space occupying lesions. The study included 103 children; male to female ratio was 1.7:1. One third of children were below 5 years of age, 31% between 5-10 years and 35% were above 10 years. The study tools included questionnaire, clinical examination and investigations including brain C.T and MRI studies. The commonest intracranial SOL was astrocytoma (35.0%), followed by abscess (19.4%) and medulloblastoma in (10.7%). Headache was found to be the main presenting symptom occurring in (59.2%).Cranial nerves involvement was the iv commonest clinical sign detected in (43.7%) followed by gait disturbance detected in (42.7%) respectively. The commonest fundal change was papilloedema (18.5%).Most of lesions detected were supratentorial (72.8%) and they were found to be commonly benign in nature (54.7%), malignant lesions were confined mainly to infratentorial area (78.6%). Malignant lesions affected males more than females (1.6:1). Ventricular dilatation was the common imaging finding detected in (46.7%). Malignant lesions (65.6%) needed V.P shunt operation more than benign lesions (35.0%). Congenital heart disease (4.8%) was a risk factor for brain abscess. Tuberculoma was detected less than expected (1.9%). The main recommendations are: To consider headache and vomiting early warning signs, proper evaluation of children and use of CT and MRI to detect lesions early. Decentralization of services and training of general doctors and pediatricians.