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Posterior Fossa Syndrome

Patient Presents

Katie is a seven-year-old right-handed white female who complained of ill-defined headaches starting last June. These headaches did not alter activities of daily living (ADLs), nor were they associated with posture, specific activity, or the time of day. A pediatric neurologist initially diagnosed Katie with sinusitis and prescribed antibiotics. The patient and family reported that the headaches improved for awhile; however, two months ago the headaches resumed and progressed to include nausea and vomiting. During the last several weeks, the family noticed a change in gait and some clumsiness. On the day of admission, Katie had been vomiting for two hours.

Parents reported that Katie was full term at delivery with no complications. No other pertinent past medical history was reported. Katie has three brothers, ages 11 years, 3 years, and 3 months old. Katie's 11-year-old brother has a history of migraines but is currently doing well.

Katie reported no complaints of double vision, earache, sore throat, shortness of breath, palpitations, abdominal pain, diarrhea, constipation, urinary frequency, or seizures. There were no remarkable vital signs or acute distress. Katie was alert and oriented.

Why would the physicians think the tumor is an astrocytoma before a biopsy is taken?