Zusammenfassung
Gliome der vorderen Sehbahn betreffen 0,6–1,2 % aller primären intrakraniellen Tumoren. 60–80 % davon treten im Kindesalter auf und umfassen in dieser Altersgruppe 1–1,5 % der Tumoren. 75 % treten innerhalb der ersten Dekade auf, 90 % in den ersten beiden Dekaden. 25 % der Tumoren sind prächiasmatisch lokalisiert, 20–40 % beteiligen die Sehnervenpapille und den Sehnerv, 20–40 % betreffen das Chiasma, 33–60 % den Tractus opticus oder die Sehstrahlung. Am häufigsten sind diese Tumoren pilozytische Astrozytome, 10–70 % der Sehbahngliome sind assoziiert mit der Neurofibromatose Typ 1. Bei kleinen Kindern mit sehr großen Tumoren kann es initial zu Wachstumsretardierung bis hin zum hypothalamischen Marasmus sowie Visusstörungen kommen, die allerdings manchmal in den frühes Lebensaltern nicht erkannt werden. Das therapeutische Vorgehen, das Für und Wider umfangreicher Resektionen und das Ausmaß der adjuvanten Behandlung ist vergleichbar mit dem Vorgehen bei diffusen Ponsgliomen bis heute noch umstritten.
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Ludwig, H.C., Alaid, A., Bock, H.C. (2018). Optische Gliome bei Kindern. In: Bächli, H., Lütschg, J., Messing-Jünger, M. (eds) Pädiatrische Neurochirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48700-6_40
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