What is the typical presentation of posterior fossa tumors in children?

• A. Ataxia and gait disturbance
• B. Vomit­ing and headaches
• C. Signs of raised ICP if large
• D. All of the above

Answer: (D)

Posterior fossa tumors in children often cause symptoms from two main effects: disruption of cerebellar function and obstruction of CSF flow leading to raised intracranial pressure. Dysfunction of the cerebellum produces ataxia and gait disturbance, with an unsteady or wide-based walk and coordination difficulties. If the tumor blocks CSF pathways, it can trigger vomiting and headaches as ICP rises, especially in the setting of hydrocephalus. When the mass is large, signs of raised ICP may become more evident, such as persistent headaches and other ICP-related symptoms. Because these outcomes can occur alone or in combination, the presentation can include ataxia, vomiting and headaches, and signs of raised ICP, making all of the above the best description.