Follow-up After Surgery for Infratentorial Hemangioblastomas in Children

Frequency of Office Visits

  • 1 and 6 months, then yearly follow-up visits: Outpatients visits should be scheduled at 1, 6, and 12 months after surgery or more frequently as needed clinically. Parents and the patient (if possible) should be informed about the risk of recurrence or new occurrences in the setting of VHL.
  • Yearly examination for pheochromocytoma in patients with VHL: Patients with VHL should also undergo annual physical examination, ophthalmoscopy, abdominal MRI, dipstick urine test, and 24-hour urine collection for detection of homovanillic and vanillylmandelic acids.

Frequency of Imaging

  • MRI at 3 and 6 months, then annually: Follow-up MRI of the brain should be obtained 3, 6, and 12 months after surgery and yearly thereafter. Annual MRI of the CNS has been demonstrated to reduce the risk of clinical VHL-related manifestations from 7.2% to 2.7% compared with biannual MRI (43).

Other Investigations Required

  • Neuropsychological tests: Neuropsychological tests are ordered in accordance with preoperative and postoperative findings.
  • Electrodiagnostic tests: Electrodiagnostic tests are performed in case of and according to the presence of postoperative neurological deficits.