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Review of presenting symptoms and time to diagnosis of children with primary brain tumours
  1. V Thomas,
  2. J Choudhury,
  3. M Hussey
  1. Paediatric Department, Poole Hospital NHS Foundation Trust, Poole, UK

Abstract

Aims To assess if there was a delay in referral and central nervous system (CNS) imaging in children who have been diagnosed with a primary brain tumour over the last 15 years at our district general hospital. To review their symptoms against criteria for CNS imaging as set out in ‘The Diagnosis of Brain Tumours in Children and Young Adults: A Guideline for Healthcare Professionals’ – a guideline developed by The Children's Brain Tumour Research Centre.

Methods Retrospective case note analysis of children diagnosed with a primary brain tumour between 1995 and 2010 at a district general hospital. Data was collected on presenting symptoms, duration of symptoms prior to referral, time between referral and being assessed by a Paediatrician and time between being seen by a Paediatrician and CNS imaging.

Results 28 children met the inclusion criteria, 18 patients (64%) were male and age at diagnosis ranged from 4 months to 15 years. The most common presenting signs and symptoms were headaches (75%), vision abnormalities (54%), nausea and vomiting (36%) and motor abnormalities (32%).11 children had a delay of greater than 10 weeks between onset of symptoms and CNS imaging, the longest delay was just over 2 years. Of these 11 children, 4 met the criteria for CNS imaging as outlined in the guidelines. The time taken from being referred to being assessed by a paediatrician ranged from the same day to several months; most children were seen on the same day that they were referred and the mean delay was 10 days. The time between being seen by a paediatrician and having CNS imaging ranged from the same day to 1 year; most children had CNS imaging on the same day or the next day.

Conclusions In order to aid earlier recognition of brain tumours the guidelines developed by The Children's Brain Tumour Research Centre need to be disseminated widely among both hospital trainees and general practitioners.

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