Pediatric brain tumors in Puerto Rico.

OBJECTIVE: To determine the frequency of pediatric brain tumors treated at the University Pediatric Hospital of Puerto Rico over a 6-year period and examine the demographic data and tumor histology of patients in different age groups. METHODS: A retrospective study was undertaken at the University Pediatric Hospital. We included patients with brain tumors that had been newly diagnosed during the period covering from January 2002 to December 2007. All cases were analyzed by age, gender, histologic diagnosis, and affected area. RESULTS: One hundred thirty-six patients were included in the study. Overall, males were more frequently affected than were females. Children in the 1 to 4 years old age group had the highest number of newly diagnosed brain tumors. Regarding anatomic location, supratentorial tumors were more frequent than were infratentorial tumors. The most common single tumor was the pilocytic astrocytoma (WHO grade I), representing 31% of the total pediatric brain tumors. CONCLUSION: Our results provide an objective platform for further epidemiological studies and for the development of local health strategies for the timely diagnosis and treatment of the most common pediatric tumors in Puerto Rico.

Endoscopic third ventriculostomy: a surgeon's experience.

INTRODUCTION: Endoscopic third ventriculostomy (ETV) is considered an alternative treatment for certain types ofhydrocephalus. Depending on patient's age and etiology of hydrocephalus, it carries a success rate of around 90%. However, as in any surgical procedure, inherent risks are present and a risk-benefit analysis must be done prior to selecting patients for this intervention. OBJECTIVE: To evaluate retrospectively the experience of ETV at the University of Puerto Rico and examine the etiological factors, demographic data and symptoms among the Puerto Rico population. This study represents the data of one neurosurgeon and is the first account of endoscopic third ventriculostomy as a mode of treatment in the Caribbean area. METHODS: Retrospective analysis was undertaken of 29 patients treated at the University Pediatric Hospital (UPH) and University District Hospital (UDH) in San Juan was undertaken Different etiologies of hydrocephalus were identified and managed. RESULTS: The most common indication for ETV was aqueductal stenosis (59%) with male predominance (55%). Also, the most common population treated were adults (72%) and the most common symptom presented were headaches (52%) and gait disturbances (43%). CONCLUSIONS: Endoscopic third ventriculostomy is a safe and effective way to treat hydrocephalus and should be considered as first choice of treatment for certain patients with hydrocephalus unless otherwise contraindicated.