title: Brain tumors in infants.
abstract: BACKGROUND
  Brain tumors in infants have different clinical presentations, anatomical distribution, histopathological diagnosis, and clinical prognosis compared with older children.
  
  
  METHODS
  A retrospective analysis was done in patients <12 months old who were operated on for primary brain tumor in Children's Hospital Medical Center since 2008 to 2014.
  
  
  RESULTS
  Thirty-one infants, 20 males and 11 females, with the mean age of 7.13 months (0.5-12) were enrolled. There were 16 supratentorial and 15 infratentorial tumors. The presenting symptoms included increased head circumference (16); bulge fontanel (15); vomiting (15); developmental regression (11); sunset eye (7); seizure (4); loss of consciousness (4); irritability (3); nystagmus (2); visual loss (2); hemiparesis (2); torticollis (2); VI palsy (3); VII, IX, X nerve palsy (each 2); and ptosis (1). Gross total and subtotal resection were performed in 19 and 11 cases, respectively. Fourteen patients needed external ventricular drainage in the perioperative period, from whom four infants required a ventriculoperitoneal shunt. One patient underwent ventriculoperitoneal shunting without tumor resection. The most common histological diagnoses were primitive neuroectodermal tumor (7), followed by anaplastic ependymoma (6) and grade II ependymoma. The rate of 30-day mortality was 19.3%. Eighteen patients are now well-controlled with or without adjuvant therapy (overall survival; 58%), from whom 13 cases are tumor free (disease free survival; 41.9%), 3 cases have residual masses with fixed or decreased size (progression-free survival; 9.6%), and 2 cases are still on chemotherapy.
  
  
  CONCLUSIONS
  Brain tumors in infants should be treated with surgical resection, followed by chemotherapy when necessary.
authors.affiliation: Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Seyyed Mohammad
authors.initials: SM
authors.lastname: Ghodsi
authors.affiliation: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Habibi
authors.affiliation: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Hanaei
authors.affiliation: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Moradi
authors.affiliation: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Nejat
keywords: Brain tumor; infants; surgical treatment