Complications of Therapy for Supratentorial Ependymomas in Children

Surgical

• Hemorrhage from the tumor.
• Neurological deficits:  These can occur if the tumor is located in eloquent areas, such as motor or visual cortex. Common sequelae including abnormal gait, difficulties with fine motor function, and impaired sensory function are seen in 35–55% of patients within 1 month after surgery but improve over time (22).
• Hydrocephalus: 30% of patients will require a ventriculoperitoneal shunt (10, 22).

Medical

• Ototoxicity: Cisplatin causes ototoxicity.

Radiation

• Cognitive and neurologic function: Cognitive and neuologic functions can be affected, but studies have not shown a decline in IQ during the first 30 months after treatment with conformal radiation (21).
• Endocrinopathy: After radiation treatment for supratentorial ependymomas, endocrinopathies such as growth hormone deficiency and adrenal insufficiency can occur (23).