Summary
Definition
History and exam
Key diagnostic factors
- headache
- nausea and vomiting
Other diagnostic factors
- behavioral changes
- diplopia
- ophthalmoplegias
- bulging anterior fontanelle
- papilledema
- nystagmus
- head tilt
- ataxia
- dysmetria
Risk factors
- age 3-8 years
- male sex
- associated inherited familial syndromes
Diagnostic tests
1st tests to order
- brain MRI
- brain CT
- histology
- cervical, thoracic, and lumbar spine MRI
- lumbar puncture
Tests to consider
- postoperative MRI
Treatment algorithm
age <3 years
age ≥3 years
Contributors
Authors
Gail Horan, MB, BcH, BAO, BMed Sci, MRCPI, FRCR
Consultant Clinical Oncologist
Department of Oncology
Addenbrooke's Hospital
Cambridge
UK
Disclosures
GH carries out lectures and paid consultancy work for Janssen, and holds shares in GenesisCare. GH is the author of a reference cited in this topic.
Fiona Harris, MBChB, MRCP, FRCR
Consultant Clinical Oncologist
Addenbrookes Hospital
Cambridge
UK
Disclosures
FH declares that she has no competing interests.
Thankamma V. Ajithkumar, MBBS, DMRT, MD, FRCR, FRCPEdin, MBA
Consultant Clinical Oncologist
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
Disclosures
TVA is the author of a reference cited in this topic.
Acknowledgements
Dr Gail Horan, Dr Fiona Harris, and Dr Thankamma V. Ajithkumar would like to gratefully acknowledge Dr Sindu Vivekanandan, Dr Barry Pizer, Dr Michael J. Fisher, Dr Phillip B. Storm, and Dr Gregory G. Heuer, the previous contributors to this topic.
Disclosures
SV, BP, MJF, PBS, and GGH declare that they have no competing interests.
Peer reviewers
David Rowed, MD
Division of Neurosurgery
University of Toronto
Toronto
Ontario
Canada
Disclosures
DR declares that he has no competing interests.
Michael Vloeberghs, MD, PhD
Professor of Paediatric Neurosurgery
Nottingham University Hospital
Nottingham
UK
Disclosures
MV declares that he has no competing interests.
Differentials
- Migraine
- Viral infection
- Ependymoma
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: central nervous system cancers
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