Peer-reviewed article
QOL-05. TUMOR LOCATION IS LESS LIKELY INFLUENCE ON COGNITIVE DYSFUNCTION IN CHILDREN
Nakajima R, Kinoshita M, Tanaka S, Nakada M ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a clinical case series examining cognitive outcomes in seven children who underwent brain surgery to remove low-grade tumors. The study found that cognitive deficits predicted from the surgical resection sites were rarely observed in practice, and when they did occur, they resolved within three months. The findings suggest that tumor location may have less influence on cognitive dysfunction than previously thought in pediatric cases.
Key points
- Seven pediatric patients with low-grade gliomas or hemangioma underwent craniotomy with mean age 13.9 years
- Cognitive deficits were predicted based on resected brain regions but occurred in only 2 of 7 patients (16.7% of estimated cases)
- Two patients who experienced post-operative cognitive decline recovered completely within 3 months
- All patients returned to school without cognitive deficits by one year post-operative
- Preoperative cognitive function was normal in all patients
Limitations
This is a very small case series (n=7) from a single hospital with no comparison group, making it impossible to generalize findings or establish causation. The study cannot determine whether observed recovery is typical or what factors predict cognitive resilience.
Abstract
Abstract INTRODUCTION Though several factors are known to influence on long-term cognitive function in children with brain tumor, the impact of tumor localization to specific cognitive function was not well known. Here we investigated the influence of local brain resection by surgery on postoperative cognitive outcome in school-aged children. METHODS Participants were seven pediatric patients who underwent craniotomy for tumor resection in our hospital (mean age, 13.9 years). Their diagnosis were WHO grade 1 or 2 glioma (n=6) and hemangioma (n=1). Tumor were mainly located in following regions; frontal, n=2; parietal, n=2; temporal, n=3 (These lesions included hippocampus or were located very close to it). Temporal assessments for cognitive function of several functional domains were performed according to tumor location until post-op 1 year. Based on MRI, we estimated cognitive dysfunctions and compared them to observational symptoms. RESULTS Preoperative cognitive function was normal in all patients. Cognitive dysfunctions estimated from resected area were as follows (cumulative total number); memory or working memory disorder, n=4; visuospatial cognitive disorder, n=3; disorder of processing speed, n=2; facial or topographical agnosia, n=2; Gerstman syndrome, n=1. Just after surgery, cognitive function was declined in two functional domains of two patients, which were only 16.7% of estimated deficit from resected region. They recovered completely until 3 months postoperatively, and returned to school without any deficits. CONCLUSIONS In pediatric lower-grade tumor, focal cognitive symptom was unlikely to be induced by local resection.