Brain Tumors and Spinal Cord Tumors
Brain tumors and spinal cord tumors in children can be benign (non-cancerous) or malignant (cancerous), and both can be life threatening. But with the right treatment, children respond well. We offer comprehensive care for your child, with all of our pediatric subspecialists available in one location.
Care at Children's
At Penn State Children’s Hospital, we treat all types of brain, spinal cord, and peripheral nerve tumors from the common to the rare. Examples include:
- Astrocytomas and oligodendrogliomas
- Medulloblastomas and other primitive neuroectodermal tumors (PNET)
- Germinomas and other germ cell tumors
- Dysembryoplastic neuroepithelial tumors (DNET) and gangliogliomas
- Benign and malignant choroid plexus tumors
- Atypical terato-rhabdoid tumors (ATRT)
These complex cases require the combined expertise of several pediatric subspecialists to provide the best care for the child. We are the only hospital in Central Pennsylvania to bring together a full complement of pediatric subspecialists—from dedicated pediatric neurosurgeons, medical oncologists, radiation oncologists, neuropathologists, and neurologists to psychologists, physical therapists, rehabilitation specialists, and more—to help your child get better.
We are members of the Children’s Oncology Group (COG), a National Cancer Institute supported clinical trials group. As part of this group, we follow treatment plans developed by cancer experts from across North America - and children treated at COG-affiliated institutions tend to have better results than children who receive care at other hospitals. Through this network, we also have access to brain tumor specialists at other institutions if we want additional opinions about the best treatment for your child.
We also have an extensive experimental therapeutics program with innovative treatments for children with recurrent and difficult to treat tumors.
To make sure that all children get the care they need, the Four Diamonds Fund pays for treatment costs not covered by insurance - including both benign and malignant tumors of the brain and spinal cord.
Thanks to the Children’s Hospital expertise in minimally invasive procedures, Nathaniel Murphy didn’t have to endure open-skull surgery to remove a brain tumor. Read Nathaniel’s story.
When you come to the Children’s Hospital for brain, spine, or peripheral nerve tumor treatment, we will use every option available to help treat your child while preserving neurological function and quality of life.
After you’ve been referred to us, one of our neurosurgeons will see you within 24 hours to diagnose the problem. We may order additional neuroimaging tests if needed. Then we’ll work with our team to determine the best treatment plan for your child.
In most cases, surgery is the first step, both to obtain a diagnosis and remove as much of the tumor as possible. For malignant tumors, we may use chemotherapy and/or radiation therapy after surgery, avoiding radiation therapy whenever possible because of the negative effect it can have on developing brains. Whenever possible, we use highly focused radiation treatments such as intensity modulated radiation therapy (IMRT) or Gamma Knife stereotactic radiosurgery to avoid injuring adjacent brain structures.
We treat benign tumors as a chronic condition, aiming to completely remove symptomatic tumors if possible while preserving neurological function and quality of life. For residual or re-growing tumors, we aim to halt tumor growth with repeat surgery or other therapies.
We offer the latest techniques for brain tumor surgery including microsurgery, making tumor removal safer and more effective than ever before. Surgical innovations we offer include:
- Frameless stereotaxis – provides image guidance during surgery, mapping the surgical instruments to MRI or CT scans performed before surgery
- Sonopet – an ultrasonic surgical system that can core tumors from the inside out with less damage to the surrounding brain
- Minimally invasive endoscopic surgery – we use endoscopic technologies in conjunction with tiny microinstruments such as the Myriad for tumor removal through an endoscope, and techniques such as corridor surgery, whenever possible that result in smaller incisions and faster recoveries
- Intraoperative monitoring – we routinely monitor a variety of brain functions in “real time” during tumor removal so we can choose the safest path for tumor removal and avoid injuring adjacent areas of the brain.
Brain tumor treatment involves multidisciplinary care, often with input from many departments including:
Penn State Pediatric Neurosurgery
30 Hope Drive, Entrance B, Suite 2200
Hershey, PA 17033
Groups, Classes & Support
Spinal Cord Injury Support Group
This group is open to those with spinal cord injuries, their families and support person. The group allows an opportunity for support, socialization and education.
Penn State Rehabilitation Hospital Cafeteria, 1135 Old West Chocolate Avenue, Hummelstown, Pa 17036
This support group meets on the third Wednesday of every month at 7:00 p.m.
Registration is not necessary and all patients and their support network are welcome to attend. Please contact Nancy Lokey for more information.
Research & Clinical Trials
Penn State Children’s Hospital is a member of the Children’s Oncology Group (COG), Pediatric Oncology Experimental Therapeutics Consortium (POETIC) and Neuroblastoma Medulloblastoma Treatment Research Consortium (NMTRC). These affiliations give our patients access to many clinical trials and the latest therapies.
Symptoms, Diagnosis & Outlook
A brain tumor is a group (mass) of abnormal cells that start in the brain. A spinal cord tumor is a growth of cells (mass) in or surrounding the spinal cord.
Symptoms may be subtle and only gradually become worse, or they may occur very quickly.
Headaches are often the most common symptom. But only very rarely do children with headaches have a tumor. Headache patterns that may occur with brain tumors include:
- Headaches that are worse when waking up in the morning and go away within a few hours
- Headaches that get worse with coughing or exercise, or with a change in body position
- Headaches that occur while sleeping and with at least one other symptom such as vomiting or confusion
Sometimes, the only symptoms of brain tumors are mental changes, which may include:
- Changes in personality and behavior
- Unable to concentrate
- Increased sleep
- Memory loss
- Problems with reasoning
Other possible symptoms are:
- Gradual loss of movement or feeling in an arm or leg
- Hearing loss with or without dizziness
- Speech difficulty
- Unexpected vision problem (especially if it occurs with a headache), including vision loss (usually of peripheral vision) in one or both eyes, or double vision
- Problems with balance
- Weakness or numbness
Spinal Cord Tumors
The symptoms depend on the location, type of tumor, and your general health. Tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years.
Tumors in the spinal cord usually cause symptoms, sometimes over large portions of the body. Tumors outside the spinal cord may grow for a long time before causing nerve damage.
Symptoms may include:
- Abnormal sensations or loss of sensation, especially in the legs (may be in the knee or ankle, with or without shooting pain down the leg)
- Back pain that gets worse over time, is often in the middle or lower back, is usually severe and not relieved by pain medicine, gets worse when lying down or straining (such as during a cough or sneeze), and may extend to the hips or legs
- Cold sensation of the legs, cool fingers or hands, or coolness of other areas
- Fecal incontinence
- Inability to keep from leaking urine (urinary incontinence)
- Muscle contractions, twitches, or spasms (fasciculations)
- Muscle function loss
- Muscle weakness (decreased muscle strength) in the legs that causes falls, makes walking difficult, and may get worse (progressive)
Exams & Diagnostic Tests
You health care provider will perform a physical exam. Infants may have the following physical signs:
- Bulging fontanelle
- Enlarged eyes
- No red reflex in the eye
- Positive Babinski reflex
- Separated sutures
The following tests may be used to detect a brain tumor and identify its location:
- CT scan of the head
- MRI of the brain
- Examination of the cerebral spinal fluid (CSF)
Spinal Cord Tumors
A nervous system (neurological) examination may help pinpoint the location of the tumor. The health care provider may also find the following during an exam:
- Abnormal reflexes
- Increased muscle tone
- Loss of pain and temperature sensation
- Muscle weakness
- Tenderness in the spine
These tests may confirm spinal tumor:
- Cerebrospinal fluid (CSF) examination
- Cytology (cell studies) of CSF
- Spinal CT
- Spine MRI
- Spine x-ray