Clinical Presentation and Neurologic Evaluation in Posterior Fossa Tumors in Children

Abstract

The major neural structures of the posterior fossa are the brainstem, cranial nerves, and the cerebellum. The signs we see in children mostly with posterior fossa tumors are ataxia, hypotonia, abnormalities in rapid alternating movements, intentional tremor, decreased deep tendon reflexes, and torticollis. The most common eye abnormalities are abducens nerve palsy and nystagmus. The symptoms that children present with posterior fossa tumors are headache, nausea, vomiting, lethargy, strabismus, and macrocephaly due to hydrocephalus and seizures. There are slight variations in the clinical presentation of different tumors. The duration of symptoms before diagnosis, the type of ataxia, and signs due to extension of tumor may differ according to the type. Careful neurologic examination is an important tool in the diagnosis of posterior fossa tumors in children.