Medulloblastoma is a malignant, invasive brain tumor arising from the cerebellar vermis.
It is the most common malignant brain tumor of childhood.
Symptoms, due to a mass effect from the tumor or to obstructive hydrocephalus, include morning headaches, nausea, vomiting, diplopia (manifestation of sixth nerve palsy), and ataxia. Vomiting often relieves the headaches.
Computed tomography and magnetic resonance imaging of the brain are used to diagnose the condition.
Treatment is surgery, usually with cerebrospinal fluid diversion, followed by chemotherapy and/or radiation therapy.
Medulloblastoma is a malignant, invasive brain tumor arising from the cerebellar vermis. The vast majority of medulloblastomas arise sporadically in the first two decades of life. As it is largely a tumor of childhood, this topic will not deal with medulloblastoma in adults, although the management is similar in adults and children.
History and exam
Key diagnostic factors
- nausea and vomiting
Other diagnostic factors
- behavioral changes
- bulging anterior fontanelle
- head tilt
- age 3-8 years
- male sex
- associated inherited familial syndromes
1st investigations to order
- brain MRI
- brain CT
- cervical, thoracic, and lumbar spine MRI
- lumbar puncture
Investigations to consider
- postoperative MRI
age <3 years
age ≥3 years
- Viral infection
- NCCN clinical practice guidelines in oncology: central nervous system cancers
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