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Urgent CT – posterior fossa tumour — RACP Paediatrics MCQ

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EasyNeurologyUrgent CT – posterior fossa tumourRACP Paediatrics

A 3-year-old has a 2-month history of progressively unsteady gait, early morning vomiting, and new-onset squint. Head circumference has increased from the 50th to the 97th centile. What is the most urgent investigation?

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Correct answer: E — CT head

Acute hydrocephalus signs (increasing head circumference, vomiting, squint/CN6 palsy) with progressive ataxia require urgent CT head to assess for posterior fossa mass with obstructive hydrocephalus. CT is preferred for urgency; MRI follows for detailed tumour characterisation. Do not delay with MRI if hydrocephalus is suspected acutely.

Reference: RCH Melbourne – 2023 – Brain Tumour CPG; RACP Paediatric Curriculum – Neurology