Diagnosis and treatment of occipital brain lesions in children

Occipital brain lesions in children represent a significant diagnostic challenge because of the wide spectrum of aetiologies and overlapping clinical features. Early recognition and accurate diagnosis are crucial for effective management and to limit long-term neurological deficits, especially in small children whose symptoms may be subtle. This narrative review evaluates common and less common causes of occipital brain lesions in children, including malformative, vascular, genetic and metabolic, infectious, inflammatory, and neoplastic conditions, examining the wide range of associated clinical presentations. Through a review of the literature and description of real-life observations, we highlight the role of a multidisciplinary diagnostic approach that integrates clinical assessment, neuroimaging, neuropsychology, and targeted testing to determine the underlying aetiology. Early recognition of often subtle visual and cognitive disturbances, coupled with targeted work-up, appropriate referral to subspecialty evaluations, and rapid institution of treatment strategies, can improve the long-term outcome considerably.