Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi
Part 8 of 9 in Diagnosis and Management of Brain Tumour
Brain Tumours in Children and Newborns: Diagnosis and Management
June 9, 2024
Brain tumours can occur at any age, including in newborns, and the diagnostic and treatment approach for children differs from adults mainly in how radiotherapy and chemotherapy are administered.
Identifying and managing childhood brain tumours
Identifying a brain tumour in a child follows the same approach as in adults. The surgical approach is also unchanged, but radiotherapy and chemotherapy protocols must be modified according to the child's age to account for its effect on a still-developing brain.
Detecting tumours in newborns
Brain tumours can be detected even in newborns. An ultrasound of the skull can serve as a screening test to check for a tumour or excess fluid in the brain, but this is only a screening tool; an MRI is required for a definitive diagnosis in a newborn, just as in older patients.
This article is based on a Jivo Masterclass session conducted by Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
Looking for a neurosurgery or brain tumour consultation? Get in touch with the Jivo team
This guide is based on a live Jivo Masterclass: Dr. Sonal Gupta taught doctors across Africa on June 9, 2024.
FROM THE LIVE Q&A
Dr. Abraa
A 19-year-old has been on epilepsy follow-up and medication for 10 years. The MRI is negative, but the EEG shows a slow-wave background. What is the next step?
Dr. Sonal Gupta
This patient should be referred for a dedicated epilepsy workup.
Frequently Asked Questions
After a complete resection of a cancerous mass, there is a void left in the brain. How does this void evolve during healing, and are there always neurological sequelae?▼
A cancer tumour can never be removed completely; microscopic cells are always left behind. Because these tumours cause significant surrounding brain swelling, the surgical cavity fills in quickly on its own, so the void itself is not a concern.
A 7-year-old girl presented with a two-week history of headache and vomiting that progressed over the last three days. MRI showed a well-defined left frontal lobe mass with a differential of metastasis versus high-grade glioma, and local doctors are recommending a frontal lobectomy. What would you recommend, and what are the likely outcomes?▼
Rather than an open frontal lobectomy, neuronavigation-guided keyhole tumour surgery using a surgical robotic system allows near-complete removal of high-grade tumours, improving survival, though high-grade tumours cannot be described as fully curable. This is typically followed by stereotactic radiosurgery and chemotherapy or immunotherapy depending on the biopsy, guided by genetic study of the tumour, which few centres worldwide perform routinely.
Is immunotherapy actually used in the treatment of brain tumours?▼
Yes. Genetic-based targeted immunotherapy is the latest advancement in brain tumour treatment.
For a 17-year-old patient showing several of these symptoms, what characteristics should guide a referral for further workup?▼
Symptoms alone do not distinguish a benign tumour from a malignant one; both can present the same way. A CT scan and MRI together can predict whether a tumour is benign or malignant with about 90% accuracy, though only a biopsy can confirm the diagnosis and grade. Any patient with these symptoms should be sent for an MRI.
How can epilepsy surgery be made practical and accessible for African patients?▼
Not every epilepsy patient needs surgery - only intractable epilepsy (uncontrolled despite adequate medication) or epilepsy caused by a visible lesion on MRI warrants it. To make this accessible, an online epilepsy clinic can review a patient's medication history and MRI findings remotely, and only call the patient to India for a surgical workup once epilepsy is confirmed to be intractable.
How is a childhood brain tumour managed differently from an adult one?▼
Identification and the surgical approach are the same, but radiotherapy and chemotherapy protocols are modified according to the child's age.
Can a brain tumour be detected in a newborn?▼
Yes - an ultrasound of the skull can screen for it, but an MRI is required for a definitive diagnosis.
In This Series: Diagnosis and Management of Brain Tumour
- 1.Brain Tumour
- 2.How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
- 3.Brain Tumour Symptoms and Which Headaches Are Red Flags
- 4.Diagnosing Brain Tumours: CT, MRI and Beyond
- 5.Brain Tumour Surgery and Radiosurgery: Treatment Options Explained
- 6.Brain Tumour Surgery: Realistic Complication Rates and Recovery
- 7.Epilepsy Surgery: Who Needs It and How It Helps
- 8.Brain Tumours in Children and Newborns: Diagnosis and Management
- 9.Real Brain Tumour Cases: Weighing Surgery Against Radiosurgery