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Last reviewed: 21 Apr 2025
Last updated: 24 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • headache
  • nausea and vomiting

Other diagnostic factors

  • behavioural changes
  • diplopia
  • ophthalmoplegias
  • bulging anterior fontanelle
  • papilloedema
  • nystagmus
  • head tilt
  • ataxia
  • dysmetria
  • lethargy

Risk factors

  • age 1 to 9 years
  • male sex
  • associated inherited familial syndromes

Diagnostic investigations

1st investigations to order

  • brain MRI
  • brain CT
  • histology
  • cervical, thoracic, and lumbar spine MRI
  • lumbar puncture
  • postoperative MRI

Treatment algorithm

Contributors

Authors

Tobey J. MacDonald, MD

Professor

Department of Pediatrics

Emory University School of Medicine

Atlanta

GA

Disclosures

TJM declares that he has no competing interests.

Acknowledgements

Dr Tobey J. MacDonald would like to gratefully acknowledge Dr Gail Horan, Dr Fiona Harris, Dr Thankamma V. Ajithkumar, Dr Sindu Vivekanandan, Dr Barry Pizer, Dr Michael J. Fisher, Dr Phillip B. Storm, and Dr Gregory G. Heuer, the previous contributors to this topic.

Disclosures

GH carries out lectures and paid consultancy work for Janssen, and holds shares in GenesisCare. GH and TVA are authors of references cited in this topic. FH, SV, BP, MJF, PBS, and GGH declare that they have no competing interests.

Peer reviewers

David Rowed, MD

Division of Neurosurgery

University of Toronto

Toronto

Ontario

Canada

Disclosures

DR declares that he has no competing interests.

Michael Vloeberghs, MD, PhD

Professor of Paediatric Neurosurgery

Nottingham University Hospital

Nottingham

UK

Disclosures

MV declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pediatric central nervous system cancers [internet publication].Full text

Louis DN, Perry A, Wesseling P, et al. The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol. 2021 Aug 2;23(8):1231-51.Full text  Abstract

Franceschi E, Hofer S, Brandes AA, et al. EANO-EURACAN clinical practice guideline for diagnosis, treatment, and follow-up of post-pubertal and adult patients with medulloblastoma. Lancet Oncol. 2019 Dec;20(12):e715-28. Abstract

Reference articles

A full list of sources referenced in this topic is available here.

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