Posterior fossa tumours in children as seen in a tertiary and referral hospital in sub-Saharan Africa

Abstract

Background: Posterior cranial fossa tumours in children results in morbidity & mortality worldwide. In Sub- saharan Africa delayed diagnostic modalities and lack of awareness of the symptoms and signs is common.Objective: To review the management of posterior fossa tumours in children.Design: A retrospective analysis of children treated for posterior fossa tumours between 2009 and 2012. Setting: Neurosurgery unit, Kenyatta National Teaching and Referral hospital. This is the only specialized unit among the public hospitals in Kenya where such patients are referred to.Results: 54 children were treated for posterior fossa tumours between 2009 and 2012. 30 males and 24 females were attended to giving M: F ratio of 1.25:1. The age varied between 1-16 years with a mean of 7.4 years. Cerebellar symptoms were the most common mode of presentation (32%) followed by headaches and vomiting. 30% of our patients were blind at presentation probably due to chronic effects of raised intracranial pressure. Out of 18 patients with histological diagnosis of meduloblastomas, over 90% were females and only 2 were male. Astrocytomas were evenly distributed at 7 males and 9 females. The mean duration of symptoms was 5.4 months while it took 6 weeks between time of diagnosis and treatment. Conclusion: Posterior cranial fossa tumours in our set- up are more common in males than females. Most cases of medulloblastomas are found among female children. The delay in diagnosis and definitive management is noted probably due to lack of awareness and expensive modalities of management.