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Objective: The purpose of this study was to determine the role and cost effectiveness of surveillance imaging at the management of pediatric brain tumors., Materials and Methods: In this study, the imaging and clinical finding of 59 patients who had been diagnosed and followed by the Dokuz Eylul University Pediatric Oncology Group as primary central nervous system tumors between 1988 and 2000 were retrospectively evaluated., Results: We found that the 87.5% of tumor recurrence occurs within 21 months and 93.8% occur within 29 months. About 25% of these recurrences were asymptomatic and these (n=16) could be detected by surveillance imaging with a frequency rate of 1.59%. The cost of imaging for our patients was calculated to be 788 US$ (mean) for a follow-up period of 24 months which would have been 739 US$ if a standard surveillance protocol would have been followed., Conclusion: Surveillance imaging is an effective follow-up in detecting symptomatic recurrence in pediatric brain tumors.

Carotid-cavernous fistulas (CCF) are reported very rarely in childhood and their clinical course and prognosis are uncertain. We report a 9-year-old boy presented with left eye swelling, neck pain and headache. The MRI findings suggested a CCF with enlarged left superior ophthalmic vein. Ocular Doppler ultrasonography revealed enlarged left superior ophthalmic vein, and arterialization of Doppler wave form. The cerebral angiogram showed normal anatomy. Control Doppler examination findings supported the diagnosis of closure of fistula. The clinical and radiological findings of this unusual presentation are discussed.