Pediatric Brain Tumour (Medulloblastoma)

• MRI of the whole brain and spine, with and without contrast, showing the tumour and any spread through the spinal fluid.
• Post-operative MRI within about 48 to 72 hours, which shows the extent of tumour removed.
• Pathology and molecular report classifying the subgroup (such as WNT, SHH, Group 3 or 4), which helps define risk.
• Spinal fluid (CSF) cytology results, usually done about two weeks after surgery.
• Details of any shunt or hydrocephalus treatment, hearing and kidney function tests, and endocrine baselines before chemotherapy and radiotherapy.

1. What subgroup and risk category is my child's tumour?
2. What proportion of the tumour was removed, and has it spread?
3. What treatment plan do you recommend and what is the intent?
4. What are the long-term effects on hearing, growth, thinking and hormones?
5. What happens if it comes back?
6. What follow-up scans and rehabilitation will be needed?

Outlook depends on risk group. In standard-risk disease in older children treated with surgery, radiotherapy and chemotherapy, a majority are long-term survivors. High-risk disease, metastases, certain molecular subtypes and very young age carry a poorer outlook. Survivors often have late effects on thinking, hearing, growth and hormones, so rehabilitation and long-term follow-up matter. The factors that change outcome are age, extent of surgery, spread, subgroup and the radiation approach.