Brain tumours in paediatrics: when should they be suspected?

A Comprehensive Study of Radiological Evaluation of Global Developmental Delay Using Mri

“…A persistent headache, visual symptoms, neurological deficits, developmental delay, poor school performance, and personality change are some of the symptoms of brain tumours making it a diagnostic challenge. 18 In our study 5 cases of tumours were seen as listed in Table 4.…”

A young child with a headache

“…[3][4][5][6][7][8][9][10] Signs and symptoms may become progressively evident, and regular monitoring is paramount. 6 Multiple red flags, and certain high-risk features such as associated seizures and focal neurological deficits, should be particularly alarming to clinicians and prompt further investigations. 9,10 CASE CONTINUED There were no red flags on further history.…”

“…10 If required, magnetic resonance imaging (MRI) is preferable to computed tomography because of its superiority in detecting posterior fossa pathology and lower radiation risk. 6 Referral to an ophthalmologist or skilled optometrist can detect subtle signs of visual disturbance (Box 1). 3,6 A lumbar puncture may be considered to measure opening pressure but is usually not required.…”

“…6 Referral to an ophthalmologist or skilled optometrist can detect subtle signs of visual disturbance (Box 1). 3,6 A lumbar puncture may be considered to measure opening pressure but is usually not required. 3 In Australia, general practitioners can order MRI under Medicare Benefits Schedule rebates if a child aged <16 years has unexplained seizures or unexplained headaches with suspected significant pathology.…”

Where are the opportunities for an earlier diagnosis of primary intracranial tumours in children and young adults?

“…Evidence on early diagnosis of intracranial tumours in children and young adults, and particularly its relationship with survival, is scarce because of the logistical cost in recruiting sufficient patients to create a traditional cohort for identifying earlier diagnostic opportunities. Advances in statistical methodology and computing power in linking routinely collected patient care records have enabled creation of a population-based cohort with histologically verified intracranial tumours for examining temporal changes in the symptoms and signs at each primary care or hospital visit, thus allowing us to investigate if an earlier diagnosis of an intracranial tumour would have been possible 11–14. Our aims are to investigate if such opportunities were limited to tumours in certain locations or existed uniformly for tumours in any location to tailor recommendations on early diagnosis for specific intracranial neoplasms.…”