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Posterior fossa tumour — RACP Paediatrics MCQ

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HardNeurology and neurodevelopmentPosterior fossa tumourRACP Paediatrics

A 9-year-old has six weeks of morning headache and vomiting. His parents note clumsiness and declining handwriting. Examination shows papilloedema and left-sided dysmetria. What is the most appropriate investigation?

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Correct answer: B — Urgent MRI brain

Morning vomiting, papilloedema and cerebellar signs suggest raised intracranial pressure from a posterior fossa lesion. Urgent MRI brain is the appropriate investigation, while lumbar puncture could be dangerous with mass effect. Progressive neurological signs are not compatible with uncomplicated migraine.

Reference: RCH Headache guideline; RACP Knowledge Guides