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Introduction: Various perioperative problems occur in patients operated on brain tumors. While many studies focused on the long-term effects of surgery, few focused on the perioperative period. The aim of this study to evaluate clinical and laboratory features and determining the factors which are effecting the outcome in operated patients for brain tumors our pediatric intensive care unit (PICU). Methods: Patients who underwent intracranial tumor surgery in the PICU during the eight-year period were retrospectively screened. Results: Seventy-four patients were included in the study, mean age was 60 (1.5-192) months, and supratentorial tumors were detected in 41 (55.4%) patients. The median length of stay (LOS) in PICU of the patients was 5 (1-150) days. When supratentorial tumor localization, ventriculoperitoneal shunt presence, central venous catheter related bloodstream infection, ventilator-associated pneumonia and other infections were evaluated, a statistically significant difference was found between the two groups when patients’ LOS in the PICU is evaluated in 2 groups of more than 15 days (77%) and less than 15 days (23%). In the postoperative period, diabetes insipidus (DI) in 12 (16%), septicemia in 9 (12%), shunt infection in 8 (10%), hydrocephalus in 7 (9%), seizures in 5 (6%), cranial nerve palsy in 5 (6%) in patients. Conclusion: Neurological sequelae increased with younger age and were more common in patients with infratentorial tumors. While a relationship was found between delta sodium and DI in the postoperative first 4 days, without relationship was found with neurological sequelae.

Retinoblastoma (RB) is the most common childhood malignant intraocular tumor. Although enucleation and external beam radiotherapy have been historically used, today the most commonly used eye-sparing approach is chemotherapy. Chemotherapy can be used in both intraocular and extraocular RB cases. Chemotherapeutic agents may be applied in different ways, including systemic, subconjunctival, intra-arterial and intravitreal routes. The main purposes of application of systemic therapy are to reduce the tumor size for local treatment (chemoreduction), or to reduce the risk of metastasis after enucleation surgery (adjuvant therapy). Intra-arterial chemotherapy with the current name “super-selective intra-arterial infusion therapy” could be applied as primary therapy in tumors confined to the retina or as a secondary method in tumor recurrence. The most important advantage of intra-arterial therapy is the prevention of systemic chemotherapy complications. Intravitreal chemotherapy is administered in the presence of persistent or recurrent vitreous seeding. The term “extraocular RB” includes orbital invasion and metastatic disease. Current treatment for orbital invasion is neoadjuvant chemotherapy followed by surgical enucleation and adjuvant chemotherapy and radiotherapy after surgery. In metastatic disease, regional lymph node involvement, distant metastases, and/or central nervous system (CNS) involvement may occur. Among them, CNS involvement has the worst prognosis, remaining at almost 100% mortality. In metastatic disease, high-dose salvage chemotherapy and autologous hematopoietic stem cell rescue therapy are the possible treatment options; radiotherapy could also be added to the protocol according to the side of involvement.