B.C., a 6-year-old first-grade student, was referred to a pediatric neurologist by his primary pediatrician for a neuro consult. He had presented with an acute onset of headaches, vomiting on waking in the morning, and progressive ataxia. The neurologist conducted a thorough neuro exam and ordered a CT scan, MRI, and lumbar puncture (LP) to look for possible tumor cells. When the LP revealed suspicious cells and the scans showed a tissue density, he was referred to a neurosurgeon for treatment of a suspected infratentorial astrocytoma of the posterior fossa.

B.C. had a craniotomy with tumor resection 5 days later. The cerebellar tumor was found to be noninfiltrating and was enclosed within a cyst, which was totally removed. B.C. spent 2 days in the neurological intensive care unit (NICU) because he was on seizure precautions and monitoring for increased intracranial pressure (ICP). A regimen of focal radiation followed after recovery from surgery. His spine was also treated because of the potential spread of tumor cells in the CSF. B.C. did not have chemotherapy because of the danger that he might develop hydrocephalus, which generally requires a ventriculoperitoneal (VP) shunt.

B.C. was discharged 6 days after his surgery with a mild hemiparesis, which was expected to resolve within the next few weeks. He was scheduled for 6 weeks of outpatient rehabilitation, and his prognosis was good.

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