Brain tumours in childhood

Abstract

Brain tumours in childhood pose an important challenge to the paediatrician. This is the most common solid tumour in children and can present in a perplexingly wide range of ways. Once the masquerading presenting features have been clarified, the clinician is then involved in delivering treatment, within a multidisciplinary team, to a relatively inaccessible organ that is highly susceptible to treatment related morbidity. Brain tumours can be classified according to their cell of origin (Table 1). The most recent World Health Organization (WHO) classification consists of no fewer than 116 histologically distinct brain tumours. 1 Childhood brain tumours are more differentiated than their adult counterparts, have a propensity to occur in the midiine, and in the main occupy the infratentorial compartment . The prognostic distinction between benign (low-grade) or malignant (high-grade) tumour types is not as clear as it is with extracranial tumours. Malignant CNS turnouts, as a rule, do not metastasize out of the CNS, but have the potential to spread along the subarachnoid pathways. Low-grade tumours, despite being benign, can have devastating effects due to their anatomical location. In the last two decades great strides have been made in improving the survival rates within this group of patients. This is predominantly due to improvements in neuro-imaging and neurosurgical techniques. The neuroradiologists are imaging tumours with high resolution magnetic resonance imaging