Pediatric brain tumors

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Pediatric brain tumors


Autonomic nervous system disorders

Horner syndrome

Orthostatic hypotension


Pediatric brain tumors


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Pediatric brain tumors

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USMLE® Step 1 style questions USMLE

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A 3-year-old boy is brought to the emergency department by his parents due to irritability and severe nausea and vomiting for the past day. His parents state that he has been eating less than usual for the past week. His temperature is 37.0°C (98.6°F), pulse is 80/min, and blood pressure is 118/75 mmHg. On physical examination, horizontal nystagmus is present, and limb movement is uncoordinated. Magnetic resonance imaging of the brain is obtained and shown below:  

Reproduced from: Wikimedia Commons    
Which of the following is most likely to be seen on histologic evaluation of the mass?  

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Pilocytic astrocytoma p. 546


Content Reviewers

Pediatric brain tumors are masses of abnormal cells that generally occur in children, and result from the uncontrolled growth of those cells within the brain.

OK - let’s start with some basic brain anatomy. First off, there’s the cerebral cortex which is the part of the brain that’s supratentorial or above the tentorium, and the cerebellum, which is infratentorial or below the tentorium.

And the brain has four interconnected cavities called ventricles, which are filled with cerebrospinal fluid - a fluid that helps provide buoyancy and protection, as well as metabolic fuel for the brain.

Highest up, are two C-shaped lateral ventricles that lie deep in each cerebral hemisphere.

The two lateral ventricles drain their cerebrospinal fluid into the third ventricle, which is a narrow, funnel-shaped, cavity at the center of the brain.

The third ventricle makes a bit more cerebrospinal fluid and then sends all of it to the fourth ventricle via the cerebral aqueduct.

The fourth ventricle is a tent-shaped cavity located between the brainstem and the cerebellum.

After the fourth ventricle, the cerebrospinal fluid enters the subarachnoid space, which is the space between the arachnoid and pia mater, two of the inner linings of the meninges which cover and protect both the brain and the spine.


Pediatric brain tumors are a group of tumors that occur in the brain of children and adolescents. They can be benign or malignant, infratentorial, or supratentorial depending on whether they are located above or below the tentorium cerebelli.

Common pediatric brain tumors include astrocytomas, medulloblastomas, and ependymomas. The diagnosis involves medical imaging, with a definitive diagnosis being made with a tissue biopsy. Treatment depends on the tumor type, tumor grade, and accessibility, and can incorporate surgical removal and some combination of radiotherapy and chemotherapy.


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