Related Experiment Videos
Intracranial tumours during the first two years of life: presenting features
G S Gordon1, S J Wallace, J W Neal
1Department of Child Health, University Hospital of Wales, Heath Park, Cardiff.
Insights
Intracranial tumors in young children are rare and can mimic meningitis. Early neuroimaging is crucial for children with neurological symptoms and a large head to ensure timely diagnosis of brain tumors.
Area of Science:
- Pediatric Neurology
- Pediatric Oncology
Background:
- Intracranial tumors in children under two years old are uncommon.
- These tumors can present with symptoms that mimic other childhood illnesses, such as meningitis.
Purpose of the Study:
- To analyze the clinical presentation and diagnostic challenges of intracranial tumors in infants and very young children.
- To emphasize the importance of early neuroimaging in suspected cases.
Main Methods:
- Retrospective review of 21 children diagnosed with intracranial tumors before age 2.
- Analysis of presenting symptoms, clinical signs, diagnostic delays, and misdiagnoses.
Main Results:
- Common symptoms included vomiting and unsteadiness.
- Enlarged occipitofrontal circumference was a frequent sign.
- Five cases were initially misdiagnosed as meningitis, leading to diagnostic delays.
Conclusions:
- Intracranial tumors in early childhood can be misdiagnosed as meningitis.
- Prompt neuroimaging is recommended for infants presenting with neurological symptoms and a disproportionately large head.
Abstract:
Between 1979 and 1994, 21 children (nine females, 12 males) with intracranial tumours diagnosed before the age of 2 years (range 2-23 months) were treated at the University Hospital of Wales. The commonest presenting symptoms were vomiting (n = 9) and unsteadiness (n = 8); the commonest presenting sign was enlarged occipitofrontal circumference (> 97th centile in 16 and > 90th centile in a further two). In five cases with signs of raised intracranial pressure, meningitis was the clinical diagnosis, and a lumbar puncture was performed. For cases with long delays in diagnosis, multiple other disorders had been considered and the significance of head enlargement had not been recognised. In very early childhood, intracranial tumours are uncommon and can mimic other disorders, especially meningitis. Early neuroimaging is advised when a child presents with recent onset of neurological symptoms and a disproportionately large head.