Stocco C, et al. – The physicians embraced this research to explain the symptoms and signs of central nervous system (CNS) tumors in a pediatric population and to evaluate the time interval between the onset of the disease and the time of the diagnosis. The earliest and commonest symptoms in children with brain tumors were headache and vomiting. Visual symptoms and signs and behavioral change were often present. In most of the children, abnormalities in the neurological examination were reported. Intracranial hypertension symptoms suggested the need for a neurological clinical examination and an ophthalmological assessment.

• Between January 2000 and November 201, the physicians conducted a retrospective observational study at their Oncology Pediatric Unit.
• A total of 75 children between 5 months and 16 years (mean age of 7.8 ± 4.7 years) were included, with male to female ratio of 3:2.

• In 51% of cases, the tumor localization was supratentorial.
• Low-grade astrocytoma (48%) was the most frequent histological type.
• Headache (31%), vomiting (31%), seizures (21%), and behavioral change (11%) were presenting symptoms.
• Headache (51%), vomiting (51%), visual difficulties (37%), seizures (24%), and behavioral change (21%) were the most common symptoms at diagnosis.
• Neurologic examination was altered in 68% of the patients by the time of diagnosis.
• The most frequent symptoms were vomiting (44%) and behavioral change (44%) in children under 4 years of age, headache (61%) and vomiting (54%) in children older than 4 years.
• Between symptoms’ onset and diagnosis, the median interval was 4 weeks (range 0 to 314 weeks).
• A longer symptom interval was correlated with younger age, infratentorial localization and low-grade tumors.
• Between the different age, location, and grade groups, the differences in symptom intervals were not statistically significant.
• As per the outcomes, survival probability was influenced by tumor grade though not by diagnostic delay or age of the child.