Persistent morning vomiting with headache, unusual drowsiness, a squint or unsteadiness needs assessment today. These suggest raised pressure inside the skull. Also seek emergency care for a seizure, or for a child who cannot be roused normally.
The commonest solid tumours of childhood. Many are curable — some with surgery alone — and outcomes depend heavily on the treatment following an established protocol from the start.
Written for parents. Childhood brain tumours differ from adult ones in type, in behaviour and in outlook, and the difference is generally in your child's favour.
Children's brain tumours occur most often at the back of the brain, in the posterior fossa. Because that region sits beside the narrow channels through which fluid drains, these tumours frequently obstruct the flow and cause hydrocephalus — which is why raised-pressure symptoms often come before any weakness or clumsiness.
The common types differ entirely from adults. Medulloblastoma is a malignant tumour of the cerebellum that spreads through the fluid pathways and is treated with surgery, radiotherapy and chemotherapy. Pilocytic astrocytoma is a low-grade tumour that is frequently cured by complete surgical removal alone. Ependymoma arises from the lining of the fluid cavities. Brainstem gliomas vary enormously — some are treatable, and a particular type, diffuse midline glioma, currently is not.
Molecular subtyping has changed this field substantially. Medulloblastoma is now divided into groups with very different behaviour and outlook, and treatment intensity is adjusted accordingly — sparing some children treatment they do not need while intensifying it for those who do.
Radiotherapy is used cautiously in young children, particularly under three, because of its effect on the developing brain. Protocols are designed to delay or avoid it in the youngest patients where possible, using chemotherapy to buy time.
The classic early pattern of a childhood brain tumour is headache on waking with vomiting that then relieves it, because pressure inside the skull rises overnight when lying flat. It is regularly attributed to migraine or a stomach upset for weeks or months. Add a new squint, a persistent head tilt, unsteadiness or a change in personality, and the case for imaging becomes strong. A child with this pattern should have a scan rather than another course of anti-sickness medicine.
Imaging first, then tissue, then molecular testing.
For several childhood tumours, whether disease has spread through the fluid pathways to the spine changes the stage and therefore the treatment. That scan is ideally done before surgery, because blood and debris afterwards make it harder to interpret. Send the brain and spine MRI reports, your child's exact age and weight, and a description of the symptoms and when each began.
Surgery is usually first, and what follows depends on the tumour type and your child's age.
Maximal safe removal by a paediatric neurosurgeon. For low-grade tumours such as pilocytic astrocytoma, complete removal is frequently curative and no further treatment is needed. For malignant tumours, the extent of removal affects outcome and is followed by further treatment. Hydrocephalus is dealt with at the same time where present.
Given according to an established protocol determined by tumour type, molecular group and age. In very young children it is also used to delay radiotherapy until the brain is more developed. Some phases can be given near home once the protocol is set, which we will map out for you.
Effective but used carefully in children because of effects on the developing brain, on growth and on hormones. Where it is needed, modern conformal techniques limit the dose to surrounding tissue. It requires daily attendance for several weeks and must be given in India.
Treatment can affect growth, puberty, thyroid function, hearing and learning. Long-term follow-up in all these areas is part of the treatment rather than an optional extra, and much of it can be arranged near your home once we set it out in writing.
These determine both treatment and outlook, and they come from the tissue. Two children with the same tumour name can need different intensities of treatment.
Radiotherapy is avoided or delayed in the very young. Protocols are built around this and it shapes the whole sequence.
A long protocol begun and abandoned loses most of its benefit. We will give you the full duration and cost before anything starts.
Complex paediatric neurosurgery needs a paediatric neurosurgeon, a paediatric neuro intensive care unit and a paediatric oncology service in the same hospital. We verify all three, and it is often why we do not recommend the best-known name.
Raised pressure inside a child's skull needs treating locally and urgently. Once it is relieved and the child is stable, planning definitive treatment here becomes safe.
Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.
Many are. Low-grade tumours such as pilocytic astrocytoma are frequently cured by complete surgical removal alone. Medulloblastoma is curable in a substantial proportion of children with full protocol treatment. Some, particularly diffuse midline glioma of the brainstem, currently are not, and we will tell you honestly which situation applies once we see the imaging and pathology.
Because several childhood brain tumours spread through the fluid that circulates around the brain and spinal cord. Whether that has happened changes the stage and therefore the treatment. The scan is best done before surgery, since blood and debris afterwards make it harder to interpret.
It is effective but carries real long-term effects on the developing brain, on growth and on hormones, which is why protocols avoid or delay it in children under three, using chemotherapy to buy time. Where it is necessary, modern conformal techniques reduce the dose to surrounding tissue. The risks and benefits should be discussed frankly for your child's specific age and tumour.
Surgery and recovery take around six weeks. If radiotherapy follows, add six to seven weeks in India because it is given daily. Chemotherapy protocols can extend over many months, and much of that can often be given near home once the protocol is written out. We will map the whole timeline before anything starts.
Many children do well, but treatment can affect learning, hearing, growth and hormone function, and follow-up in all these areas is part of the care rather than an afterthought. Younger children treated with radiotherapy are most at risk. Ask for a written long-term follow-up plan that your local doctors can carry out.
Tell us before treatment begins rather than partway through. A protocol started and abandoned loses most of its benefit, and an interrupted course is worse than a properly planned alternative. We will give you the full expected cost and duration upfront, and where the numbers do not work we will say so and help you consider what is achievable.
Send the brain MRI and, if done, the spine MRI, along with your child's exact age and weight. Tell us when each symptom began.
Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.
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