Pediatric Neurology

Carol Foster, M.D.

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Speciality: Headaches and migraines, ages 12+

Ang Li, M.D.

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Speciality: Sleep medicine, ages 12+

Michael Pearlman, M.D., PhD

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Speciality: General neurology
Our pediatric neurologists treat the following conditions:

Brain Tumors

A brain tumor is the growth of abnormal cells in the brain. When most normal cells grow oldor get damaged, they die, and new cells take their place. Sometimes, this process goeswrong. New cells form when the body doesn"t need them, and old or damaged cells don"tdie as they should. The buildup of extra cells often forms a mass of tissue called a growth ortumor.

Types of Tumor

Brain tumors are alsoclassified as either primary or metastatic.When a brain tumor originates in thebrain it is referred to as a primary braintumor. Primary brain tumors are named according to the type of cells or the part of the brain in which they begin. Some of the common types of primary brain tumors include:

  • Astrocytoma: tumor arises from star-shaped glial cells called astocytes
  • Meningioma: tumor arises in the meninges (membrane covering brain and spinal cord)
  • Ependymoma: tumor arises from cells that line the ventricles or the central canal of the spinal cord
  • Brain stem glioma: tumor occurs in the lowest part of the brain

Metastatic brain tumors begin ascancer elsewhere in the body and thenspread to the brain.

Brain tumors are classified as eitherbenign (non-cancerous) or malignant (cancerous).

  • Benign brain tumors do not contain cancer cells, they can be removed and seldom grow back. They don"t spread to other parts of the body but may become malignant.
  • Malignant brain tumors contain cancer cells and are generally more serious and often are a threat to life. They are likely to grow rapidly and crowd or invade the nearby healthy brain tissue, and may break away from malignant brain tumors, spreading to other parts of thebrain or to the spinal cord. They rarely spread to other parts of the body.

Grades of Tumor

Doctors group brain tumors by grade. The grade of a tumor refers to the way the cells look under a microscope, and include

  • Grade I: tissue is benign. Cells look nearly like normal brain cells, and they grow slowly.
  • Grade II: tissue is malignant. Cells look less like normal cells than do the cells in a Grade I tumor.
  • Grade III: malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing (anaplastic).
  • Grade IV: malignant tissue has cells that look most abnormal and tend to grow quickly.

Risk factors

The exact causes of brain tumors are not clear, but there are certain risk factors that could lead to brain tumors:

  • Ionizing radiation from sources such as high dose x-rays (such as radiation therapy from a large machine aimed at the head) can cause cell damage that leads to atumor.
  • Family history, although rare. Only a very small number of families have several members with brain tumors.


The symptoms of a brain tumor depend on tumor size, type, and location. The most commonsymptoms include:

  • Problems with memory
  • Problems balancing orwalking
  • Headaches
  • Muscle jerking ortwitching (seizures orconvulsions)
  • Nausea and vomiting
  • Changes in speech,vision, or hearing
  • Numbness or tingling inthe arms or legs
  • Changes in mood,personality or ability toconcentrate


If you have symptoms that suggest a brain tumor, your doctor will conduct a physical examand ask you about your personal and family health history.You may have one or more of the following tests:

  • Neurologic exam tests for vision, hearing, alertness, muscle strength, coordination and reflexes. Your doctor also examines your eyes for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.

  • Imaging tests like MRI and CT scan to detect abnormalities such as a tumor
  • Angiogram involves the injection of a dye into the blood stream, which is viewed on an X-ray. Tumor or blood vessels feeding into a tumor can be detected.
  • Spinal tap involves the removal of a sample of the cerebrospinal fluid (fluid found in spaces in and around the brain and spinalcord) and testing for abnormalities
  • Biopsy involves the removal of tissue and testing for abnormalities


Depending on the type and grade of brain tumor, location, size, and your age and general health, your doctor will suggest the following:

  • Surgery involves the removal of the tumor. It is done either as an open brain surgery or as a less invasive procedure using an endoscope (lighted instrument with a camera attached to it).
  • Radiation therapy uses high-energy radiations like X-rays to kill the tumor cells. It usually follows surgery and is sometimes used if surgery is not recommended.
  • Chemotherapy is the use of drugs to kill the cancer cells. They can be given through the mouth, IV or as wafers, which are inserted into the brain.

You may get a combination of these treatments.

Dr. Pearlman's Pediatric Practice Locations

499 E. Hampden Ave.
Suite #360
Englewood, CO 80113

10099 RidgeGate Pkwy
Suite #480
Lone Tree, CO 80124