Medulloblastoma is a fast-growing, malignant brain tumor that is most common in children and develops in the cerebellum. Symptoms include headaches, nausea, vomiting, and problems with balance or vision, often caused by a buildup of pressure in the brain. Diagnosis involves MRI and biopsy, with treatment typically combining surgery, radiation, and chemotherapy, although survival rates are improving

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Medulloblastoma: Causes, Symptoms, Diagnosis & Modern Treatment Approaches

Medulloblastoma is one of the most common malignant brain tumors found in children. Although it can occur in adults, it is primarily a pediatric cancer that grows rapidly and arises in the cerebellum, the part of the brain responsible for coordination, movement, and balance. Despite its aggressive nature, significant advancements in treatment over the past few decades have greatly improved survival rates.

This article provides a clear and comprehensive look at what medulloblastoma is, how it presents, and how it is treated today.

What Is Medulloblastoma?

Medulloblastoma is a high-grade (Grade IV), fast-growing brain tumor that originates from primitive neuroectodermal cells. These cells are normally involved in brain development but, when they start dividing uncontrollably, they form a tumor.

Although medulloblastomas occur in the cerebellum, they can spread through the cerebrospinal fluid (CSF) to other areas of the brain and spinal cord. This ability to spread makes early diagnosis and treatment extremely important.

Who Is Affected?

  • Most common in children aged 3–8 years

  • Represents 20–25% of all childhood brain tumors

  • Rare in adults, but can occur at any age

  • Slightly more common in boys than girls

Common Symptoms

Because medulloblastomas grow quickly, symptoms often appear suddenly and worsen over time. Most symptoms are caused by increased intracranial pressure—pressure inside the skull—due to the tumor blocking the flow of cerebrospinal fluid.

Typical Symptoms Include:

  • Headaches, especially in the morning

  • Nausea and vomiting

  • Balance problems, clumsiness, or trouble walking

  • Vision issues, including blurred or double vision

  • Neck stiffness

  • Fatigue or irritability

  • Difficulty with coordination (hand-eye movements)

In some cases, children may show behavioral changes, declining school performance, or changes in handwriting due to cerebellar involvement.

How Is Medulloblastoma Diagnosed?

Early diagnosis is critical for effective treatment. Physicians use several steps:

1. Neurological Examination

To look for problems with balance, coordination, reflexes, and eye movements.

2. MRI Scan

The gold standard for detecting brain tumors. An MRI provides detailed images of:

  • The tumor’s size and location

  • Whether it has spread to the spinal cord

  • Pressure buildup in the brain

3. Biopsy or Surgical Removal

A sample of the tumor tissue is examined under a microscope to confirm the diagnosis and identify the molecular subtype.

4. Lumbar Puncture

This checks for tumor cells in the CSF to determine if the cancer has spread.

Treatment Options

Treatment for medulloblastoma is typically multimodal, meaning it involves several methods used together.

1. Surgery

The first step is usually to remove as much of the tumor as safely possible. Even partial removal can relieve pressure on the brain.

2. Radiation Therapy

After surgery, targeted radiation is used to kill remaining tumor cells.

  • Children older than 3 often receive craniospinal irradiation (radiation to both brain and spine).

  • In very young children, radiation may be reduced or delayed to avoid long-term side effects.

3. Chemotherapy

Chemotherapy is often combined with surgery and radiation to destroy or shrink residual cancer cells.
It may be given:

  • Before radiation (to reduce tumor size)

  • After radiation (to prevent recurrence)

4. Emerging Treatments

Ongoing research includes:

  • Targeted therapies based on tumor genetics

  • Proton therapy (more precise radiation)

  • Immunotherapy in selected cases

Prognosis and Survival Rates

Survival rates for medulloblastoma have improved significantly with modern treatment.

  • Average 5-year survival rate: 70–85%, depending on risk category

  • Children diagnosed early and treated aggressively have better outcomes

  • Molecular subtyping (WNT, SHH, Group 3, Group 4) now helps predict prognosis more accurately

Patients often require long-term follow-up for cognitive, hormonal, or neurological side effects.

Living With Medulloblastoma

After treatment, children may need:

  • Physical therapy

  • Speech therapy

  • Hormone replacement (in some cases)

  • Academic support

With proper rehabilitation and medical care, many survivors return to normal daily activities.

Conclusion

Medulloblastoma is a serious but increasingly treatable childhood brain tumor. Advances in imaging, neurosurgery, molecular diagnostics, and therapy have significantly improved survival and quality of life for many children. While treatment can be challenging, early detection and comprehensive care offer the best outcomes.

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