Abstract
A 3-year-old boy with a dorsally exophytic tumor arising from the rostral medulla
presented with a chief complaint of a change in his emotional behavior, most notably
anxiety and paroxysmal crying often followed by syncope. Magnetic resonance imaging
revealed that the tumor pushed on the dorsal surface of the medulla and displaced
the medulla anteriorly, and also displaced the cerebellar vermis upward and slightly
posteriorly. Tissue from a partial resection was diagnosed as a pilocytic astrocytoma.
The symptoms did not improved after surgery, but did improve clinically after chemotherapy
with vincristine and carboplatin, at which time MR showed a reduction in tumor size.
We diagnosed the paroxysmal crying as ‘pathological crying’ and the syncope with increased
anxiety as ‘emotional vasovagal syncope’. This case stresses the importance of recognition
of this rare presentation as an indication of a medullary tumor.
Keywords
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Article info
Publication history
Published online: December 28, 2015
Accepted:
December 15,
2015
Received in revised form:
December 14,
2015
Received:
July 21,
2015
Identification
Copyright
© 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
