CNS Tumors

Management Principles:

  • Airway, breathing, circulation stabilization
  • Neurosurgery/neuro-oncology consultation
  • NPO + IVF
  • Avoid dehydration.
  • Pre-surgical laboratory tests (electrolytes, CBC, coagulation studies, blood type and cross-matching)
  • Intravenous steroids (dexamethasone) with GI-protective agent after discussing with NSx
  • Magnetic resonance imaging of the brain and spine with and without intravenous contrast
  • Ensure appropriate Na levels
  • R/o elevated ICP and if evidence of intracranial hypertension, STAT NSx evaluation
  • Preoperative endocrine laboratory tests for suprasellar tumors
  • Ophthalmologic examination
  • Seizure prophylaxis for patients presenting with or at high risk for convulsions
  • Social work consultation
  • Lumbar puncture for CSF cytology and tumor markers (for suspected CNS germinoma) is generally performed 7 to 10 days postoperatively if there are no contraindications

See the following attachment for an overview of common pediatric CNS tumors: Brain_Tumors.pdf

Useful links: