SUPRATENTORIAL TUMORS IN INFANTS

Three hundred and ninety-six paediatric (below 15 years of age) patien ts with brain tumours were treated at our institute in the last 4 year s. Eighty-two of the tumours were located supratentorially. These 82 p atients included 14 infants (below 1 year of age), who made up 3.5% of all paediatric patients with brain tumours and 17% of those with brai n tumours in a supratentorial location. There was a male preponderance , and two-thirds of the 14 patients were within their first 6 months o f life. Increasing head size, vomiting and failure to thrive were the common presenting features. One infant presented with asymmetric skull growth. The tumours tended to be large, occupying almost the entire a ffected cerebral hemisphere; histological types included astrocytomas, malignant astrocytomas, glioblastoma multiforme, primitive neuroectod ermal tumours, malignant choroid plexus papillomas and malignant terat omas. Two children had congenital tumours and another two tumours, in children with associated lobar agenesis, were thought to be congenital in origin. associated hydrocephalus was present in seven patients, bu t precraniotomy shunt was required in only two patients. The periopera tive (within 1 month) mortality was 57%. Only 30% of the patients surv ived for more than 1 year after surgery and chemotherapy. The longest survival was 20 months. Delay in diagnosis, poor general condition pri or to surgery, and the high vascularity and malignant nature of these tumours accounted for the poor results.