Which of the following is a typical presenting symptom of pilocytic astrocytoma?

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

Answer: (A)

Pilocytic astrocytoma in children most often arises in the cerebellum, so the presenting picture centers on posterior fossa dysfunction. A cerebellar tumor disrupts coordination and balance, causing ataxia and gait problems, and as the mass grows it can raise intracranial pressure, leading to headaches and vomiting. This combination—headache with vomiting alongside ataxia—is the classic presentation for a cerebellar tumor like pilocytic astrocytoma. Visual loss is more typical of optic pathway glioma, seizures tend to reflect cortical involvement, and morning vomiting alone can occur with raised ICP but does not specifically reflect cerebellar dysfunction.