When 18-year-old Jordan “Jordy” Hansen talks about the big moments in his young life – hockey is usually involved. But one of the hockey memories that sticks isn’t about scoring a game-winning goal. It was at a tournament in 2017 and his mom noticed what turned out to be a symptom of a brain tumor.
Children’s Minnesota is thrilled to announce Becker’s Hospital Review recognized the organization’s neurosurgery program on its list of 70 hospitals and health systems with spine and neuroscience programs to know in 2023.
Children’s Minnesota is now home to North America’s first pediatric hybrid intraoperative magnetic resonance imaging (iMRI) suite equipped with both moving-scanner and moving-patient MRI technology in the same surgical space.
An optic pathway glioma is a subset of low grade astrocytoma that grows in a portion of the optic pathway (optic nerve, optic chiasm, optic radiations). Optic gliomas typically grow as an infiltrative lesion with poorly defined borders. Because they are infiltrative they often extend and involve the entire optic pathway. They also frequently extend into adjacent structures, such as the hypothalamus. Optic chiasmatic and hypothalamic gliomas are often considered a single entity because of their ability to infiltrate into both compartments regardless of the site of origin of the tumor. These tumors originate from astrocytes, which are star-shaped brain cells. Astrocytes are a type of glial cell which function to support the surrounding cells. Optic pathway/hypothalamic gliomas account for 4-6% of all brain tumors in children and 30% of all pediatric gliomas. The peak incidence is during the first decade of life.
Germ cell tumors (GCTs) arise from primordial germ cells that did not migrate appropriately during embryonic development. Residual primordial germ cells deposited in the brain give rise to intracranial germ cell tumors. These residual primordial germ cells tend to be located in the midline of the body; therefore intracranial germ cell tumors typically originate in the suprasellar or pineal region. Rarely GCTs originate in other midline intracranial locations including the basal ganglia, thalamus, and ventricles. Intracranial germ cell tumors are twice as likely to be located in the pineal region compared to the suprasellar region. Approximately 5-10% of cases have “bi-focal” disease, defined as simultaneous involvement of the suprasellar and pineal region. Intracranial germ cell tumors mainly occur in adolescents and young adults (peak incidence is 10-12 years of age) and are more commonly seen in boys. These tumors have the capacity to spread (metastasize) through the spinal fluid (leptomeningeal spread).
Medulloblastoma (also referred to as primitive neuroectodermal tumor or PNET) arises from the primitive or embryonal cells of the cerebellum. Medulloblastoma is a tumor that arises within the cerebellum and often grows into the fourth ventricle. These tumors have the capacity to spread (metastasize) through the spinal fluid (leptomeningeal spread), occurring in approximately 30% of cases, and they rarely spread to bone and bone marrow.
An ependymoma is a tumor that arises from the ependymal cells, which line the ventricles of the brain and the central canal of the spinal cord. Ependymomas are typically found in three major locations: the posterior fossa, the supratentorium, and the spinal cord. Over 90% of ependymoma arise from the brain and 10% arise for the spinal cord. Ependymomas rarely spread (metastasize) from their site of origin.
DNET or Ganglioglioma are slow growing tumors that are composed of both glial and neuronal elements. They are very rare, accounting for less than 1-2% of brain tumors. They typically develop from the supratentorial region, mainly the temporal lobe or frontal lobe. Ganglioglioma are rarely located in other areas of the brain and spinal cord. These tumors do not have a capacity to metastasize or spread beyond the primary site of origin. DNET and Ganglioglioma are indolent, slow-growing tumors. Very rarely ganglioglioma will undergo malignant transformation. These tumors are mainly seen in children and young adults. The average age of diagnosis is 9 years of age. There is no known cause for DNET and Ganglioglioma.
A craniopharyngioma is a benign tumor arising from squamous cell and is found along the path of the primitive craniopharyngeal duct and adenohypophysis. Craniopharyngiomas are located intracranially but outside the brain, near the anterior base of the cerebrum, in a location termed the sella and suprasellar region. Craniopharyngiomas will frequently grow to involve the third ventricle, hypothalamus, optic chiasm and pituitary gland. A Craniopharyngioma is classified as a benign tumor, but its impact can be significant due to its location near critical structures.
Cerebellar Juvenile Pilocytic Astrocytoma (JPA) makes up about 15-25 percent of brain tumors seen in children. This type of tumor arises from an astrocyte, which is a type of glial cell. Astrocytes make up the supportive tissue of the brain. Astrocytes are named for their star-like appearance. Cerebellar astrocytomas arise from the cerebellum, which is the area of the brain responsible for controlling coordinated movement, balance and posture. Cerebellar JPA tend to occur before the age of 10 years, most commonly between the ages of 6 and 9 years of age. Patients with cerebellar JPA have an excellent prognosis.