Experiencia en el manejo de meduloblastomas en el servicio de neurocirugía pediátrica del Hospital General del Centro Médico Nacional La Raza

the experience presented here is the management of medulloblastomas in pediatric neurosurgery of the general hospital, national medical center "la raza" from january 1999 to june 2004. it is an observational, transversal, retrospective and descriptive work. it included patients with diagnosis of medulloblastoma from 1 day old to16 years old, both sexes. all of them with histological studies from neuropathology. excluding those cases that had a different diagnosis from medulloblastoma as another tumor in the central nervous system, infection, vascular malformation and concomitant disease. results: 21 patients were studied, with an average age of 6.4 years old, 38% female and 62% male, the principal symptom was vomiting 76.19%, nausea 66.66% and headache 61.9%, we found papilledema 76.19% and dysmetria 66.67% in the neurological exploration. the radiological finding was an isodense mass, with contrast enhancement, lobed 90%, located on meddle line 69.1%, hydrocefalus 95.2%. the most used approach was the medium suboccipital craniectomy with resection on posterior arch of atlas. the lesion had capsule in 100%, yellow-grey color with reddish center, and classical histology in 76% and desmoplasic 24%, complications 14.2%. mortality was 23%, with karnosfsky of 100:9, 95:1, 90:4, 90:1. conclusions: ms is a frequent lesion of childhood between 3 to 9 year olds, minimal masculine predominance, the radiological and histological features are typical and they are similar to these reported in the international bibliography. the best approach was the medium suboccipital craniectomy and resection on posterior arch of atlas, the mortality was high when the brainstem was infiltrated by the medulloblastomas.