Timothy C. Hain, MD • Page last modified: March 7, 2021
The cerebellar astrocytoma is a relatively benign tumor, usually (70-80%) found in children. The most common age of discovery is 5-15 years old.
For tumors that are removed and which were not invading the brainstem, the 25 year tumor free survival is about 90%. They constitute nearly 1/3 of all pediatric brain tumors.
The most common presentation is headache with nausea and vomiting. Frontal headaches are the most common. Posterior headache with neck stiffness suggests cerebellar herniation. Nausea is generally in the morning (morning sickness ?) and traditionally may be associated with "projectile vomiting".
Pappilledema occurs in 90% of patients. If prolonged, it may be associated with optic atrophy.
Ataxia occurs in 95% of children on diagnosis. This will be seen as an unsteady gait in younger children, and clumsiness in older children.
Dysmetria and nystagmus, diplopia, and facial weakness are also common signs.
A young woman, who was otherwise well, was physically very active, and enrolled in a medical residency. One day she developed a headache. She was seen in the emergency department where she worked and a large cerebellar tumor was discovered. After being seen by neurosurgery, removal was recommended. After the tumor was resected, she developed severe unsteadiness and uncoordination. However, after 6 months passed, she was able to return to her training program.
Commentary -- here this patient had a large cerebellar tumor, but without any evidence for damage.
This site's web page on cerebellar disorders, contains many illustrations of cerebellar tumors.