Dr Spoudeas is a co author of the above journal article. Dr Spoudeas writes: “This is the first and largest longitudinal series of 90 infants, all under 3 years of age, followed for neuroendocrine problems to maturity in the same centre. It describes the potentially devastating consequences of deep midbrain (hypothalamic) injury which affect these very young children, and are due far more to the position and recurrence of the tumour, and failure to control it by repeated medical treatments, despite a radiation avoidance strategy. It clearly shows time- and age-dependent windows for evolving hormone and behavioural change, seen only if the same children are followed expectantly from infancy to adulthood . Despite mitigating and timely hormone replacement, the effects of hypothalamic injury on neurodevelopment, growth and puberty, behaviour and achievement, can be devastating. School absences for repeated treatment cycles, without pre-emptive and continuous neuropsychological and educational rehabilitation, further reduce quality of life and milestone attainment. This is why we believe further parallel surveillance and targeted therapeutic neurodevelopmental and cognitive interventions, informed by interval complex health assessment from diagnosis, during and beyond cure, are vital to better understand the nature of the injury and truly effect a cure.”
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