Abstract:
Survivors of pediatric brain tumors are at high risk for long-term neuropsychological difficulties. In the current case study, we present longitudinal neuropsychological data spanning 10 years (from age 9 to 19 years) of a patient with a rare, very large, bifrontal, embryonal tumor with abundant neuropil and true rosettes (ETANTR), which is typically associated with poor survivorship and significant neurological impact. Results demonstrated that the patient had largely intact cognitive functioning with specific difficulties in executive functioning, fine motor skills, and adaptive functioning at her most recent neuropsychology 10-year follow-up. These results highlight outcomes for a patient with remarkable resiliency in the context of numerous risk factors (a very large tumor size, multi-modal treatment, and seizure history). Patient protective factors (a high level of cognitive reserve, family support, and appropriate comprehensive educational services) likely contributed to the patient\'s favorable neuropsychological outcome. The patient\'s age at brain tumor diagnosis (9 years) and associated treatment was at a critical period of development for emerging higher order cognitive functions which likely impacted acquisition of executive functioning skills and secondarily adaptive skill outcomes. Consequently, pediatric brain tumor survivors with ETANTR or other frontal tumors require targeted screening of executive functions and proactive interventions.
摘要:
小儿脑肿瘤的幸存者长期神经心理困难的风险很高。在目前的案例研究中,我们提供了一个罕见患者的10年(从9岁到19岁)的纵向神经心理学数据,很大,双额叶,具有丰富的神经纤维和真正的玫瑰花结的胚胎性肿瘤(ETANTR),这通常与低生存率和严重的神经系统影响有关。结果表明,患者的认知功能基本完整,执行功能有特殊困难,精细的运动技能,和适应功能在她最近的神经心理学10年随访。这些结果突出了在众多风险因素(非常大的肿瘤大小,多模式治疗,和癫痫发作史)。患者保护因素(高水平的认知储备,家庭支持,和适当的全面教育服务)可能有助于患者的良好神经心理学结果。患者在脑肿瘤诊断时的年龄(9岁)和相关治疗处于新兴高阶认知功能发展的关键时期,这可能会影响执行功能技能和次要适应性技能的获得。因此,患有ETANTR或其他额叶肿瘤的儿童脑肿瘤幸存者需要有针对性的执行功能筛查和积极干预.