Brain & Spinal Tumors

Treatments & Procedures

What We Treat

At NewYork-Presbyterian, we have expertise in all types of brain and spinal tumors in children of all ages, from infancy to early adulthood, including:

• Atypical Teratoid/Rhabdoid Tumor (AT/RT)
• Pediatric brain tumors
• Brainstem gliomas
• Central nervous system tumors
• Diffuse intrinsic pontine glioma (DIPG)
• Ependymoma
• Gliomatosis cerebri
• Thalamic glioma
• High-grade gliomas
• Hydrocephalus

How We Diagnose Brain and Spinal Tumors

When you bring your child to NewYork-Presbyterian, you benefit from a team approach that starts during your very first visit, when we begin assembling a plan of care. In addition to a physical examination and complete medical history, a neurological examination is typically performed to establish symptoms and identify any possible problems. This exam consists of assessing eye movements, sensation, hearing, sense of smell, motor function, swallowing, balance, and coordination.

Imaging studies are the key component of diagnosing brain and spinal tumors in children. Magnetic resonance imaging (MRI) or a computed tomography (CT) scan may be used and conducted with or without contrast enhancement. Imaging studies can have certain risks, particularly among growing children. Our experienced pediatric neurosurgeons recommend the study that’s best for your child. The study is performed in a Pediatric Neurosurgery Center with technology made for children and their unique needs.

Depending on the suspected diagnosis, additional procedures may be conducted that include:

• A cerebral angiogram is a minimally invasive procedure that is conducted to visualize the blood vessels in the tumor, specifically for highly vascular tumors.
• A spinal tap, a procedure in which a special needle is inserted into the spinal canal, can be performed to acquire a sample of cerebrospinal fluid. The fluid may be tested to detect cancer cells or establish whether an infection or other problems are present.
• A serum tumor marker test involves drawing blood to test for tumor markers that can reveal a particular tumor type.
• Magnetic resonance spectroscopy (MRS) can detect the chemical composition of the tumor, which in turn can be used to identify the tumor type.
• Positron emission tomography (PET) scan can be used to detect malignant tumor cells by injecting radioactive glucose so that it can be traced in the body. (Since they are more active than normal cells, malignant tumor cells take up more glucose for fuel.)

A biopsy is usually conducted before or during surgery to provide a confirmed diagnosis and guide treatment decisions.

How We Treat Brain and Spinal Tumors

When we design a regimen of brain or spinal tumor treatment for your child, we aim to choose therapies that are as effective as possible while minimizing the risk of long-term side effects. Your child's treatment may include one or more of the following:

Surgery

• We carefully plan your child's surgery to remove tumor tissue while sparing healthy tissue and areas of the brain needed for vital functions.
• Our neurosurgeons have particular expertise in endoscopic neurosurgery, a minimally invasive approach using small telescopes and high-resolution video cameras to see into the brain, and more recently, the spinal canal. Working through a small incision, we can perform operations for certain tumors, with minimal trauma to the brain or spinal cord. This surgical approach results in a shorter hospital stay for your child and a quicker return to normal activities.

Chemotherapy

• Your child may receive chemotherapy according to regimens specifically geared toward children.
• We are conducting research to refine the delivery routes of chemotherapy and to develop more targeted anticancer agents that zero in on the specific molecules causing brain or spine tumor growth.

Radiation Therapy

• Because radiation to the brain and spine can cause developmental delays, we limit its use in children and only use it when better treatments are unavailable.
• When needed, we use the lowest doses possible and continuously ensure radiation safety.

Investigational Therapies

• To make progress against pediatric brain and spine tumors, we need to develop and assess new treatments in clinical trials. Your child may have the opportunity to participate in a clinical trial of a novel therapy.