Z.O. is a 3-year-old boy with no significant medical history. He is brought into the emergency depart-
ment by the emergency medical technicians after experiencing a seizure lasting 3 minutes.
His parents
report no previous history that might contribute to the seizure. On questioning, they state that they have
noticed that he has been irritable, has had a poor appetite, and has been clumsier than usual over the
past 2 to 3 weeks. Z.O. is admitted for diagnosis and treatment for a suspected brain tumor. A magnetic
resonance imaging (MRI) scan of the brain shows a 1-cm mass in the posterior fossa region of the brain,
and Z.O. is diagnosed with a cerebellar astrocytoma grade II. The tumor is contained, and the treatment
plan will consist of a surgical resection followed by chemotherapy.
Which of these are common presenting symptoms of a brain tumor? Select all that apply.
a. Headaches, especially on awakening
b. Vomiting with eating
c. Diarrhea
d. Ataxia
e. Seizures
f. Pallor
a, d, e
Headaches, vomiting not related to meals or eating, ataxia, and seizures are potential signs
and symptoms of a brain tumor and are generally a result of increasing intracranial pressure (ICP).
Vomiting with eating, diarrhea, and pallor are not associated with increased ICP.
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