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Central nervous system (CNS) tumors are the second most common cause of cancer in children when incidence rates of cancer are estimated according to the Indian population dynamics based on 2011 consensus. As per the estimates, CNS tumors account for 20.1% of cancer burden in children aged between 0 and 14 years and 16.8% when 0 to 19 years age group is considered. The most common pediatric brain tumors are astrocytoma and medulloblastoma followed by other embryonal tumors, craniopharyngioma, and ependymal tumors. The incidence of CNS tumors in children from India is similar to the western high-income countries, other than slightly higher incidence of craniopharyngioma in Indian children.

Subacute sclerosing panencephalitis (SSPE) is a late progressive fatal central nervous system sequelae of measles infection. The diagnosis is made based on clinical and electroencephalography (EEG) findings and confirmed by elevated titers of anti-measles antibodies in cerebrospinal fluid. The usual clinical presentation is in the form of progressive behavioral change, cognitive decline, and myoclonic jerks with some cases presenting in an atypical manner in the form of ataxia, epilepsy, and stroke. EEG is quiet characteristic in the form of periodic discharges of slow wave complex. Magnetic resonance imaging (MRI) early in the disease is usually normal with abnormal scans showing focal leukodystrophy, predominantly in the posterior cerebral white matter, and development of cortical atrophy with disease progression. Cord involvement is not common in SSPE. We report a child with SSPE who had initial presentation with cerebellar ataxia, acute progression of encephalitis, and atypical EEG findings. MRI brain on the initial presentation showed very subtle and focal abnormality which later progressed to have disseminated brain lesions and dorsal cord myelitis and further in the disease course showed cerebral venous sinus thrombosis. This case report emphasizes that SSPE can have very atypical presentation with rapid deterioration and can mimic as acute encephalitis or demyelinating disease.

Pediatric head trauma is very common and accounts for most of the emergency hospital visits. It is also the most common cause for a pediatrician to refer a child for neuroimaging. Pediatric head injury causes lot of morbidity and mortality in children and can be due to accidental or abusive injury. Falls are most common in small children, whereas motor vehicle accident is more common in older children and adolescents. Pediatric brain injury differs from adult brain injury due to immature brain, mechanism of injury, and difficulty in neurological evaluation in children. The radiologist needs to be familiar with these to correctly interpret the scans and guide clinicians in appropriate patient care.

A one and half-year-old baby boy presented with subacute regression of milestones in all domains. On examination, he had spastic dystonic quadriparesis. Reflexes were brisk. Magnetic resonance imaging of the brain showed diffuse cavitating leukodystrophy involving bilateral periventricular white matter, centrum semiovale, and corona radiata. Magnetic resonance spectroscopy revealed a lactate peak and serum lactate levels were also elevated. Genetic studies revealed compound heterozygous autosomal recessive mutations in IBA57 gene. This case illustrates a rare mitochondrial encephalopathy called multiple mitochondrial dysfunction syndrome-3 caused by a novel IBA57 gene mutation.

Germ cell tumors are rare tumors and may pose a diagnostic dilemma. We present a 15-year-old boy with insidious onset right hemiparesis followed by polyuria and polydipsia. Later, he also developed cognitive decline and speech disturbances. Serial magnetic resonance images (MRIs) over a 2-year period showed progressive atrophy of the left caudate nucleus, along with Wallerian degeneration of the left internal capsule and crus of midbrain. Further in the course, imaging revealed an ill-defined signal intensity involving left ganglio-capsulo-thalamic region with increased perfusion which was suggestive of basal ganglia germinoma. Beta human chorionic gonadotropin levels were mildly elevated. This case illustrates an uncommon presentation of a central nervous system germinoma which is often misdiagnosed in the early stages because of its atypical symptomatology and MRI findings.

Cystic changes in the lungs in neonatal age group as well as children are commonly encountered in day-to-day practice of paediatric chest imaging. It is therefore important to know the patterns of cystic disease, many of which are classical with definitive treatment options, to enable appropriate clinical care. This article briefly reviews the common conditions presented in our patient population with cystic changes in the lungs. The lesions have be classified as Congenital or autoimmune and Acquired conditions. The acquired lesions are largely infective in nature and represent a wide variety of infectious conditions.

Congenital radial head dislocation is a rare anomaly of the pediatric musculoskeletal system. The most common type is posterior, with anterior and lateral dislocations being less common. Unilateral cases are even more uncommon and were earlier thought to be non-existent. Our case report describes a young girl with unilateral congenital anterior radial head dislocation with progressive development of cubitus valgus deformity, which is a very rare occurrence. On reviewing literature, only few such cases have been described. Our patient also had a history of developmental dysplasia of hip and a congenital intra-hepatic porto-systemic shunt, which in addition to the morphological appearances of the radial head and capitellum, suggested a congenital etiology.