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Symptoms and time to diagnosis in children with brain tumours
Ditte Marie Klitbo1, Rine Nielsen, Niels Ove Illum
1Department of Paediatrics, Odense University Hospital, 5000 Odense C, Denmark.
Insights
Delayed diagnosis of pediatric brain tumors is common. Early recognition of symptoms like vomiting, headache, and ataxia can significantly improve diagnosis times in children.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Clinical Pediatrics
Background:
- Pediatric brain tumors present with diverse clinical symptoms, often leading to diagnostic delays.
- Understanding symptom patterns is crucial for timely intervention in pediatric neuro-oncology.
Purpose of the Study:
- To investigate the relationship between brain tumor localization, presenting symptoms, and diagnostic intervals in children.
- To identify key symptoms that may indicate an earlier consideration of brain tumors in pediatric patients.
Main Methods:
- Retrospective analysis of clinical data from 55 children (aged 0-17) diagnosed with brain tumors in Southern Denmark.
- Correlation of tumor location with prehospital symptoms obtained through parental and general practitioner interviews.
Main Results:
- 41% of tumors were supratentorial, 59% infratentorial.
- Supratentorial tumors commonly presented with vomiting (42%), seizures (37%), and headache (31%).
- Infratentorial tumors frequently manifested as headache (62%), vomiting (55%), and ataxia (48%), with median prediagnostic intervals of 30-75 days for these symptoms.
Conclusions:
- Diagnosis of pediatric brain tumors is frequently delayed relative to symptom onset.
- Considering brain tumors earlier in children presenting with relevant symptoms like vomiting, headache, or ataxia can improve diagnostic timeliness.
Introduction:
Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy.
Material And Methods:
Clinical data from children aged 0-17 years from Southern Denmark were analysed retrospectively and the results were correlated with data on prehospital symptoms obtained from interviews with parents and general practitioners.
Results:
A total of 55 children diagnosed during a period of five years were indentified and 31 interviews were obtained. A total of 19 (41%) of the tumours were supratentorial hemispheric and midline and 27 (59%) were infratentorial. At supratentorial localisations, 42% experienced vomiting as their first symptom followed by seizures in 37% and headache in 31%. At infratentorial localisations, headache occurred in 62%, vomiting in 55% and ataxia in 48% of the cases. The prediagnostic symptomatic interval had a median duration of 30 days with vomiting (range 3-330 days), a median of 75 days with headache (5-730 days) and a median of 75 days with ataxia (1-730 days).
Conclusion:
Diagnosis is often late in relation to the presenting symptoms. An earlier diagnosis may be achieved if a brain tumour is considered as soon as any child presents with the relevant symptoms.
Funding:
Not relevant.
Trial Registration:
ISRCTN88306789.
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