Intracranial tumors in the first year of life

Introduction: Intracranial tumors are the second most common pathologies in patients between 0 and 19 years of age. At younger ages, embryonal tumors are more frequent, with an infratentorial location. There is a high morbimortality given by the mass effect the tumor generates, but also given the different treatments available, which creates a great challenge for decision-making. The Gold-Standard imaging method for the characterization and follow-up is MRI with contrast.
Objective: To analyze the imaging findings of intracranial tumors in patients under 1 year of age and their relationship with tumor aggressiveness.
Method: Retrospective cohort study. Patients ≤1 year old with a diagnosis of intracranial tumor and available magnetic resonance imaging, evaluated between the years 2010 and 2022, were included. Clinical information and imaging characteristics of the tumors were obtained. A total of 11 patients were included. The most frequent reasons for consultation were increased head circumference (27.3%) and vomiting (27.3%).
Results: We found six supratentorial tumors and five infratentorial tumors. Seven tumors showed diffusion restriction, nine enhanced after intravenous contrast administration, and two presented leptomeningeal dissemination. Deviation of the midline was observed in eight patients, and hydrocephalus in six cases. Among the tumors, six were glial tumors (54.5%), two were teratoid rhabdoid tumors, two were neural tumors, and one was an anaplastic ependymoma. Five patients underwent surgical treatment, three received chemotherapy; the remaining patients did not receive oncological treatment. Seven patients had a 5-year survival, with three of them showing normal neurological development while four patients presented neurological sequelae.
Conclusions: The detection of these lesions and their radiological characteristics, especially their location, can assist in the management of patients under one year of age with intracranial tumors.