Sir.—The article by Flores et al1 was unhelpful. The reasons for delay in diagnosing pediatric brain tumors are impossible to ascertain. How long did patients have symptoms before they presented to a physician? Is it a physician or patient education problem?
Did Flores et al suggest that headaches, weight loss, behavior changes, seizures, or "other" are indications for a computed tomographic scan of the head?
Were "presenting signs and symptoms" the ones that had been ignored for so long or the ones that sparked computed tomographic scanning and referral?
Also, what evidence is there that a delay of 26 weeks from onset of symptoms changes the prognosis of brain tumors? None of the references cited contains such evidence.