Numbers Brain tumours are the leading cause of death from childhood cancer. We estimate that approximately 300 children are diagnosed each year in the US with DIPG (interpolating this to the world population will lead to a few thousand globally). [lylansoulifoundation.org]

On physical examination the infant had stridor, increased oral secretions, axial hypotonia, right esotropia and facial weakness. [casereports.bmj.com]

Table 1 Symptoms and signs at presentation ( n 48) Symptoms (%) Gait disturbance 61 Headache 44 Weakness of the limbs 42 Diplopia 40 Dysphagia 15 Vomiting 12 Deafness 10 Paraesthesia 6 Tinnitus 6 Nasal voice 6 Hiccup 2 Signs (%) Cranial nerve involvement [brain.oxfordjournals.org]

Although the exact presentation will vary according to location and size of the tumor, in general patients will exhibit a combination of 4 : ataxia cranial nerve palsies long tract signs hydrocephalus The duration of symptoms is usually much shorter in [radiopaedia.org]

tract signs, and ataxia (of trunk and limbs). [emedicine.medscape.com]

Pontine and medullary DMG present insidiously with brainstem signs (cranial nerve deficits, long tract signs) and progress inexorably, usually causing death in 2 years. [neuropathology-web.org]

Six months later, he presented ataxia syndrome with lateropulsion, star gait, dysarthria, aphasia, vertigo, and altered mental state. MRI showed an increase in the size of the tumor to 4.7 x 3.9 x 4.1 cm. [elsevier.es]

Still, she continued to participate in her freshman classes, often turning in handwritten homework as use of a computer screen triggered agonizing headaches and vertigo. [acco.org]

Additionally, depending on the tumour’s localization and the patient’s age, the following symptoms can occur: rapidly increasing head-circumference (macrocephalus), developmental delay, headaches, backaches, nausea and vomiting in the morning, dizziness [kinderkrebsinfo.de]

DDx: Midbrain tegmental glioma Rhombencephalitis Non-neoplastic inflammatory cellular infiltrates Rx: Radiation therapy chemotherapy A 4-year-old girl with new-onset right hand tremor and several-day history of ataxic gait and headache View Case [ajnr.org]