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Paediatric brain tumours, what to watch for - and how a diagnosis is reached.

The second most common childhood cancer, but one that specialist teams are increasingly good at finding early and treating well. Here is what parents and carers need to know.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against NICE NG12, HeadSmart and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance on urgent referral, MRI-led diagnosis and specialist neuro-oncology care.

Key facts

Paediatric brain tumours at a glance.

The essentials, in plain English - what it is, the types, and how a diagnosis is reached in the UK today.

  • What it is

    A tumour arising within the brain or surrounding structures in a child - the second most common childhood cancer after leukaemia.

  • Common types

    Medulloblastoma, astrocytoma and other gliomas, ependymoma, and craniopharyngioma - each behaves and is treated differently.

  • Where they arise

    Many childhood brain tumours - especially in younger children - develop in the posterior fossa, at the back of the brain.

  • Key warning signs

    Persistent or recurrent headache, especially worse lying down or in the morning with vomiting, balance problems and behavioural change.

  • How it is found

    MRI brain scan is the key diagnostic tool, guided by NICE NG12 and HeadSmart red-flag criteria for urgent referral.

  • Who treats it

    A specialist commissioned paediatric neuro-oncology multidisciplinary team - neurosurgery, oncology, endocrinology and psychology together.

Why this guide matters

Early recognition changes what comes next.

Paediatric brain tumours are rare, frightening to think about, and treatable in most children. The three points below shape everything else on this page.

  • Symptoms can be subtle at first

    Headache, vomiting or a change in behaviour can look like many ordinary childhood illnesses - knowing the pattern that matters helps you act sooner.

  • Red flags mean same-day referral

    NICE NG12 and HeadSmart criteria exist precisely so a child with concerning symptoms is seen and scanned quickly, not months later.

  • Care is genuinely multidisciplinary

    Neurosurgery, oncology, endocrinology, rehabilitation and psychology work as one team around your child, from diagnosis through years of follow-up.

How the diagnosis is made

From first symptoms to a clear plan.

The steps a UK GP, emergency team or specialist will normally follow, in order - so you know what to expect and why.

  1. 01

    Recognising

    Recognising the pattern

    A GP or emergency clinician notes persistent headache, vomiting, unsteadiness or behavioural change and checks against HeadSmart red-flag criteria.

  2. 02

    Recognising

    Examination and red-flag review

    Growth and head circumference (in infants), gait, coordination, eye movements and pupil responses, and a check for a bulging fontanelle.

  3. 03

    Recognising

    Same-day urgent referral

    Under NICE NG12, red-flag features trigger same-day referral for urgent specialist assessment - this is not a wait-and-see pathway.

  4. 04

    Confirming

    MRI brain scan

    The key diagnostic investigation - it shows the tumour’s location, size and likely type, and guides everything that follows.

  5. 05

    Confirming

    Specialist MDT and biopsy

    A specialist commissioned paediatric neuro-oncology team reviews the scans and arranges biopsy or resection for histological and molecular diagnosis.

  6. 06

    Assessing

    Staging for spread

    Spine MRI and CSF cytology assess whether the tumour has spread, depending on the type - important for tumours prone to seeding, such as medulloblastoma.

  7. 07

    Assessing

    Endocrine and functional assessment

    When the tumour involves the hypothalamic-pituitary region, hormone levels and growth are assessed alongside vision and neurological function.

Typical timeline: same-day referral to a full specialist plan, usually within days.

Symptoms

What to watch for in your child.

No single symptom confirms a brain tumour, but certain patterns - and certain combinations - deserve urgent assessment.

  • Persistent or recurrent headache

    Often worse lying down or first thing in the morning, sometimes waking the child, and frequently with vomiting.

  • Morning vomiting

    Vomiting that clusters with headache, particularly on waking, can signal raised pressure inside the skull.

  • Balance and coordination problems

    Unsteadiness, clumsiness or a change in gait, especially with tumours in the posterior fossa affecting the cerebellum.

  • Behavioural or personality change

    New irritability, regression, low mood or a drop in school performance that is out of character.

  • Visual disturbance

    Blurred or double vision, squint, or loss of part of the visual field - always worth an urgent eye and neurological check.

  • Seizures

    A new seizure in a child, particularly without fever, warrants urgent assessment and imaging.

  • In infants - head growth and fontanelle

    Rapidly increasing head circumference or a tense, bulging fontanelle can be the only early sign in babies.

  • Red flag - endocrine disturbance

    Growth failure or early puberty can point to a tumour affecting the hypothalamic-pituitary region and needs specialist review.

Treatment

How treatment is planned in the UK.

Surgery, radiotherapy and chemotherapy are combined and sequenced by a specialist commissioned team, built around your child's age and tumour type.

  • Maximal safe surgical resection

    Where feasible, surgery aims to remove as much tumour as possible while protecting healthy brain tissue and function.

  • Radiotherapy

    Used with care, particularly in very young children, given the developing brain - timing and dose are planned by the specialist team.

  • Chemotherapy

    Used alone or to bridge treatment - in young children, chemotherapy can allow radiotherapy to be safely delayed until the brain is more developed.

  • Specialist neuro-oncology MDT

    A commissioned paediatric neuro-oncology team plans and coordinates surgery, radiotherapy and chemotherapy as one pathway, not separate decisions.

  • Rehabilitation

    Physiotherapy, occupational therapy and neuropsychology support recovery of movement, learning and daily function.

  • Endocrine management

    Hormone replacement and monitoring for children whose pituitary or hypothalamic function is affected by the tumour or its treatment.

  • Long-term follow-up

    Ongoing review for late effects of treatment - growth, cognition, hormone function and secondary health risks - often into adulthood.

  • Family psychological support

    Structured emotional and practical support for the child and family, alongside the medical treatment plan.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP, paediatrician or specialist team knows your child and their history and can tell you which parts apply to them. If you are worried, get seen - today, not next week.

  • NICE. Suspected cancer: recognition and referral (NG12).

  • HeadSmart - Be Brain Tumour Aware. Symptom checklist and referral guidance.

  • Children’s Cancer and Leukaemia Group (CCLG). Guidance on paediatric brain tumours.

  • International Society of Paediatric Oncology (SIOP Europe). Brain tumour treatment guidance.

Red flags

When to seek help immediately.

Most childhood headaches and stomach upsets are nothing serious. These are the situations that need same-day emergency assessment.

  • Signs of raised intracranial pressure

    Persistent morning headache with vomiting, drowsiness or a decreasing level of consciousness needs same-day emergency assessment.

  • New or worsening seizures

    A first seizure, or a change in seizure pattern, in a child warrants urgent review and imaging.

  • Rapid neurological decline

    Sudden weakness, new squint, worsening balance or loss of previously achieved skills is an emergency, not a watch-and-wait situation.

  • Bulging fontanelle or rapid head growth

    In infants, this can be the only early warning sign and needs prompt paediatric assessment.

  • Cranial nerve signs

    Facial weakness, swallowing difficulty or abnormal eye movements can indicate a tumour pressing on the brainstem.

  • Torticollis or head tilt

    A persistent, unexplained head tilt in a young child can be an early sign of a posterior fossa tumour.

  • Endocrine emergencies

    Signs of diabetes insipidus (excessive thirst and urination) or adrenal insufficiency need urgent endocrine and oncology input.

  • Spinal cord symptoms

    Back pain with leg weakness or bladder or bowel change can signal tumour spread down the spine and needs urgent imaging.

  • Family or carer concern

    A parent or carer who feels something is seriously wrong should always be listened to and taken seriously - trust that instinct.

Living with it

Support for the whole family, not just the diagnosis.

Four things that make the biggest difference through treatment and beyond - leaning on the team around you, planning for school, keeping long-term reviews, and accepting support.

A quiet reminder

You do not have to hold this alone.

A specialist team, a named nurse and charity support exist precisely for the questions that come up between appointments.

  1. 01 Team

    Lean on the MDT

    A named clinical nurse specialist and the wider neuro-oncology team are there to coordinate care and answer questions between appointments.

  2. 02 School

    Plan for school and learning

    Early contact with the school and access to educational psychology support helps manage time off treatment and any learning changes.

  3. 03 Follow-up

    Keep long-term reviews

    Growth, hormones, hearing, vision and cognition are checked regularly for years after treatment ends - these appointments matter even when your child feels well.

  4. 04 Support

    Accept support for the family

    Siblings and parents carry their own strain - charities and hospital psychology teams offer support built around the whole family, not just the child.

Frequently asked

Everything we get asked about paediatric brain tumours.

Quick answers on symptoms, urgent referral, diagnosis and how treatment is planned.

  • What is a paediatric brain tumour?

    A tumour arising in the brain or surrounding structures in a child. It is the second most common type of childhood cancer after leukaemia, and includes several distinct types such as medulloblastoma, astrocytoma, ependymoma and craniopharyngioma.

  • What are the warning signs parents should know?

    Persistent or recurrent headache - particularly worse lying down or in the morning with vomiting - balance or coordination problems, unexplained behavioural change, visual disturbance and seizures. In infants, watch for rapidly increasing head circumference or a bulging fontanelle.

  • How quickly should a child be seen?

    Under NICE NG12 and HeadSmart guidance, red-flag symptoms warrant same-day urgent referral for specialist assessment. Do not wait to see if symptoms settle on their own.

  • How is a brain tumour diagnosed in a child?

    MRI brain scan is the key diagnostic tool. If a tumour is found, a specialist commissioned paediatric neuro-oncology team arranges biopsy or surgery for histological diagnosis, and further scans to check for spread where relevant.

  • How are childhood brain tumours treated?

    Treatment is planned by a specialist multidisciplinary team and may combine maximal safe surgical resection, radiotherapy and chemotherapy. Radiotherapy is used cautiously in very young children because of the developing brain, and chemotherapy can bridge treatment until radiotherapy is safer.

  • What support is available after treatment?

    Rehabilitation - physiotherapy, occupational therapy and neuropsychology - alongside long-term follow-up for late effects such as endocrine, cognitive and growth changes. Family psychological support is offered throughout, not only during active treatment.

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