MULTIPLE CAUSES OF CEREBROVASCULAR EVENTS IN CHILDREN WITH TUMORS OF THE PARASELLAR REGION

Cerebrovascular arterial occlusion is a rare but devastating event cau sing long-term morbidity in children with tumors in the parasellar reg ion. While usually associated with radiation therapy, there are a vari ety of host, tumor and treatment factors which predispose patients to significant vasculopathy. Case reports of 5 patients from St. Jude Chi ldren's Research Hospital with tumors in the parasellar region who pre sented with or developed vascular occlusive disease are summarized. Mu ltiple factors are identified in these cases which probably impacted o n the development of cerebral arterial occlusion with or without moyam oya syndrome. These include, but are not limited to, neurofibromatosis , tumor encasement of major cerebral vessels, surgical alterations, an d radiation therapy. The literature supports multiple, potentially int eractive etiologies for the development of vascular events in these pa tients, suggesting that their development is not simply a phenomenon r elated to radiation therapy.