Clinical Presentation and Evaluation

Symptoms and signs are generally the same for all posterior fossa tumors (Table 3) and no particular sign or symptom is specific for medulloblastoma. Hydrocephalus is present at the time of diagnosis in the vast majority of cases. In addition to symptoms of a mass lesion, these children may have cranial nerve deficits and radicular pain (Chapter 2, Fig. 24). In some unfortunate cases, medulloblastomas can present with CNS dissemination. The frequency of medulloblastoma is increased in 2 genetic syndromes: nevoid basal cell carcinoma syndrome (Gorlin's) and Turcot's syndrome.

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