Extended Cranial Ultrasound Views in Infants with Acute Brain Stem/Infratentorial Lesions: Diagnosis of a Progressive Midline Glioma in a 6-Week-Old Infant

Abstract Central nervous system (CNS) tumors are the most common solid in children and adolescents. However, neonates aged younger than a year, they very rare. Clinical presentation is often subtle nonspecific. When neurological symptoms apparent at this age, cranial ultrasound (CUS) done as initial evaluation, with standard approach through anterior fontanel (AF), followed by further imaging, such magnetic resonance imaging (MRI), if necessary. We report first neonatal case of rapidly progressive diffuse midline glioma positive for histone H3 K27M mutation (World Health Organization [WHO] grade IV) which using extended (transmastoid) CUS studies mastoid fontanelle (MF) second month life defined lesion brainstem.