Brain and spinal tumours: contemporary challenges in clinical practice

Brain and spinal tumours in children present serious diagnostic challenge for a wide range of practitioners, are common enough to appear regularly as a problem for rehabilitation in hospital, community and school. The range of treatments and their consequences are identified and explored in the way they are selected and delivered to young children versus older children as a consequence of their impact upon brain development. The specific clinical approaches to different tumour types and the impact of their anatomical presentation, biological characteristics are described including spinal cord tumours. The importance of integrating clinical research with daily clinical practice is emphasized especially the importance of obtaining tissue from tumours suitable for biological characterization for clinical practice and translational research. The current challenges and likely lines of development for optimizing the care pathway for children and young people are discussed and the challenge of making progress in diffuse pontine brainstem glioma is used as an example of the ongoing need to use research based strategies as a basis for optimized clinical care.