Medulloblastoma: Early Signs, Risks, and Treatment Advances

Medulloblastomas, the most common malignant brain tumor in children, account for approximately 20% of all paediatric brain tumors. This form of brain cancer typically affects young people. It begins in the cerebellum, the part of the brain responsible for balance and coordination. This aggressive tumour is caused by abnormal cell proliferation in the developing nervous system. Environmental variables and genetic mutations are thought to play a part in its development, while the exact explanation is unknown.

The goal of ongoing research is to better understand medulloblastoma and develop more targeted treatments. Thanks to advances in molecular profiling, multiple subtypes of this cancer have been identified, allowing for more personalised treatment strategies.

Symptoms

The symptoms of medulloblastoma differ depending on the size and location of the tumour. Common symptoms include persistent headaches, particularly in the morning or at night, which are frequently accompanied by nausea and vomiting. Children who struggle with balance and coordination may walk unsteadily or exhibit ataxia. Other neurological symptoms include head bobbing, involuntary eye movements (nystagmus), dizziness, and double vision. Lethargy, disorientation, and increased intracranial pressure may also occur due to cerebrospinal fluid accumulation (hydrocephalus). Early diagnosis of these symptoms is critical for receiving timely medical care and improving treatment outcomes.

Common Early Symptoms

1. Morning or Nighttime Headaches – Persistent headaches, often worse in the morning or after waking up, due to increased pressure inside the skull.
2. Nausea and Vomiting – Unexplained nausea or vomiting, especially in the morning, which may not be linked to food or illness.
3. Balance and Coordination Problems – Difficulty walking, frequent stumbling, clumsiness, or unsteady gait (ataxia).
4. Dizziness – Episodes of lightheadedness or trouble maintaining balance.
5. Vision Changes – Blurred or double vision, difficulty focusing, or involuntary eye movements (nystagmus).
6. Fatigue and Lethargy – Increased tiredness, sluggishness, or difficulty staying alert.
7. Irritability or Behavioral Changes – Unexplained mood swings, irritability, or difficulty concentrating.

Since these symptoms can also be caused by other conditions, it is important to seek medical attention if they persist or worsen. Detecting the condition early increases the likelihood of effective treatment and improves overall outcomes.

Causes

While the precise cause of medulloblastoma is unknown, genetic and environmental factors are thought to play a role in its development.

• Syndromes such as Gorlin and Turcot are known to elevate the risk of developing medulloblastoma. Mutations in specific genes may also trigger abnormal cell growth, leading to tumour formation.
• Environmental factors, including childhood exposure to radiation therapy in the head and neck region, have been identified as potential risk factors.
• Other suspected contributors include exposure to certain chemicals, toxins, or prenatal conditions, such as maternal infections or medication use during pregnancy.

While these factors may increase susceptibility, they do not guarantee the development of the tumour, and research is ongoing to better understand their role.

Risk Factors

Various factors have been linked to a higher risk of developing medulloblastoma.

• Age plays a major role, as most medulloblastoma cases are diagnosed in children under 10, with the highest incidence between ages 3 and 5.
• Boys are more commonly affected than girls.
• Genetic predisposition is also a key factor, with individuals having a family history of brain tumors or genetic syndromes like Gorlin and Turcot facing a higher risk.
• Previous exposure to radiation therapy, particularly to the head and spine, is associated with a higher risk of developing medulloblastoma later in life.

By understanding the symptoms, diagnosis, treatment, causes, and risk factors of medulloblastoma, medical professionals and researchers can work toward improving prevention, early detection, and treatment strategies, ultimately enhancing outcomes for affected individuals.

Diagnosis

Diagnosing medulloblastoma typically begins with a neurological examination, followed by an MRI brain scan to identify the presence of a tumour. Since medulloblastoma may resemble other brain tumors, a definitive diagnosis is made after surgical removal, where a pathologist examines the tumor cells under a microscope. A lumbar puncture may be conducted to check cerebrospinal fluid for cancer cells, aiding in the detection of cancer spread. A thorough diagnosis helps doctors devise the most effective treatment plan tailored to the child’s condition.

Treatment

Medulloblastoma treatment aims to remove as much of the tumour as safely possible while managing intracranial pressure caused by swelling or hydrocephalus. The typical treatment plan includes a combination of surgery, radiation therapy, and chemotherapy.

• Surgery is the first step to excise the tumour, and in some cases, a shunt may be placed to drain excess cerebrospinal fluid.
• Steroid treatments may also be used to reduce swelling.
• Post-surgical radiation and chemotherapy help target any remaining cancer cells and prevent the tumour from spreading or recurring.

Although this multimodal approach has led to survival rates of up to 75%, each treatment, especially radiation therapy, can have long-term developmental effects on children. Parents should discuss all treatment options, potential risks, and benefits with their healthcare providers.

Conclusion

Medulloblastoma is a serious but treatable brain tumor that primarily affects youths. Early discovery of symptoms such as chronic headaches, nausea, balance issues, and vision changes is critical for accurate diagnosis and treatment. Medical advances such as radiation therapy, chemotherapy, and surgery have significantly improved survival rates and outcomes. The goal of current clinical trials and genetic research is to develop increasingly specific and effective medicines. We can improve the prognosis for children with this challenging condition by raising awareness, financing research, and ensuring timely medical evaluation. If you suspect your child is experiencing any symptoms, visit a doctor right away.

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