Pediatric Central Nervous System Tumor Diagnosis, Complications, and Emergencies

Central nervous system tumors are the most common solid malignancy in childhood and the leading cause of cancer-related mortality in children. With an average of 13 new patients being diagnosed daily with a central nervous system tumor, many of these patients will present to the emergency department for evaluation and management. Furthermore, many children experience complications and/or adverse effects directly from the tumor itself, from multimodality treatment (ie, surgery, radiation therapy, and/or chemotherapy), and/or as long-term survivors. Oncologic emergencies include increased intracranial pressure, spinal cord compression, seizures/status epilepticus, central diabetes insipidus, and adrenal insufficiency. Evaluation and management by emergency medicine practitioners are critically important for these patients in all phases of their diagnosis and treatment and can contribute significantly to an improved prognosis.