Pilocytic astrocytoma typically presents with which of the following symptom sets?

• A. Headache, ataxia, vomiting
• B. Visual loss
• C. Morning vomiting
• D. Seizures

Answer: (A)

Pilocytic astrocytoma in children most often involves the cerebellum, so you see signs of cerebellar dysfunction plus raised intracranial pressure from the mass. The combination of headache, vomiting, and ataxia reflects this pattern: ataxia from direct cerebellar involvement causes gait and coordination problems, while the tumor’s pressure on surrounding CSF pathways raises intracranial pressure, producing morning headaches and vomiting. Visual loss is more typical of optic pathway glioma, and seizures are more common with cortical, supratentorial tumors, making those options less characteristic for a pediatric cerebellar pilocytic astrocytoma.