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Abstract
RÉSUMÉ
Les tumeurs du système nerveux central sont les tumeurs solides les plus fréquentes de l’enfant, représentant 20 % des cancers. Les tumeurs les plus rencontrées sont à l’étage sus-tentoriel et sont les gliomes et les craniopharyngiomes. A l’étage sous-tentoriel ce sont les astrocytomes pilocytiques et les médulloblastomes cérébelleux. Nous rapportons le cas d’un patient de 14 ans, venu consulter pour une diplopie binoculaire évoluant depuis 3 mois. L’examen ophtalmologique révèle une paralysie du VI gauche isolée. Aucun signe d’hypertension intracrânienne n’est retrouvé. L’imagerie met en évidence une lésion ovalaire pontique gauche aux contours bien définis. Le malade a été référé en neuro chirurgie. Toute paralysie oculomotrice en contexte non traumatique chez le sujet jeune, même peu bruyante sur le plan clinique doit imposer une imagerie systématique du système nerveux central.
ABSTRACT
Central nervous system tumors are the most common solid tumors of child, accounting for 20% of cancers. The tumors most frequently encountered in the supratentorial space are gliomas and craniopharyngiomas. On the infratentorial space, they are pilocytic astrocytomas and cerebellar medulloblastomas. We reported the case of a 14 years old patient who came to consult for binocular diplopia that has been evolving for 3 months. Ophthalmologic examination revealed an isolated paralysis of the left VI nerve. No signs of intracranial hypertension was found. Imaging revealed a left oval pontic lesion with well-defined contours. The patient was referred to neuro surgery. All oculomotor paralysis in a non-traumatic situation in young subjects even slightly noisy clinically, must impose systematically central nervous system imaging.
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References
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- Merino P, Gómez de Liaño P, Villalobo JM, Franco G, Gómez de Liaño R. Etiology and treatment of pediatric sixth nerve palsy. J AAPOS. 2010;14:502–5.
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- Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2):19-24.
- Raimondi AJ, Choux M, Di Rocco C. Posterior Fossa Tumors: Principles of Pediatric Neurosurgery, Springer-Verlag 1993. p 214.
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- Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D. Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol 2007;8:685–95.
- Thiesse P, Jaspan T, Couanet D et al. Un protocole d’imagerie des tumeurs cérébrales de l’enfant. J Radiol 2001;82:11-6.
- Gusnard DA. The pediatric central nervous system. In: Vanel D, Stark D, editors. Imaging strategies in oncology. London: Martin Dunitz; 1993. p. 49-63.
- Klimo P Jr, Pai Panandiker AS, Thompson CJ, Boop FA, Qaddoumi I, Gajjar A, et al. Management and outcome of focal low-grade brainstem tumors in pediatric patients: the St. Jude experience. J Neurosurg Pediatr, 2013; 11(3): 274.
- Kramm CM, Wagner S, Van Gool S, Schmid H, Sträter R, Gnekow A et al .Improved survival after gross total resection of malignant gliomas in pediatric patients from the HIT-GBM studies. Anticancer Res. 2006 Sep-Oct 26(5B):3773-9.
References
Azarmina M, Azarmina H. The six syndromes of the sixth cranial nerve. J Ophthalmic Vis Res. 2013 Apr;8(2):160-71.
Merino P, Gómez de Liaño P, Villalobo JM, Franco G, Gómez de Liaño R. Etiology and treatment of pediatric sixth nerve palsy. J AAPOS. 2010;14:502–5.
Lee MS, Galetta SL, Volpe NJ, Liu GT. Sixth nerve palsies in children. Pediatr Neurol. 1999;20:49–52.
Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2):19-24.
Raimondi AJ, Choux M, Di Rocco C. Posterior Fossa Tumors: Principles of Pediatric Neurosurgery, Springer-Verlag 1993. p 214.
Barkovich AJ. Intracranial, orbital, and neck tumors of childhood. In: Barkovich AJ, editors. Pediatric Neuroimaging. New-York: Raven Press; 2000. p. 443-580.
Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D. Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol 2007;8:685–95.
Thiesse P, Jaspan T, Couanet D et al. Un protocole d’imagerie des tumeurs cérébrales de l’enfant. J Radiol 2001;82:11-6.
Gusnard DA. The pediatric central nervous system. In: Vanel D, Stark D, editors. Imaging strategies in oncology. London: Martin Dunitz; 1993. p. 49-63.
Klimo P Jr, Pai Panandiker AS, Thompson CJ, Boop FA, Qaddoumi I, Gajjar A, et al. Management and outcome of focal low-grade brainstem tumors in pediatric patients: the St. Jude experience. J Neurosurg Pediatr, 2013; 11(3): 274.
Kramm CM, Wagner S, Van Gool S, Schmid H, Sträter R, Gnekow A et al .Improved survival after gross total resection of malignant gliomas in pediatric patients from the HIT-GBM studies. Anticancer Res. 2006 Sep-Oct 26(5B):3773-9.