A 6-Year-Old Girl Is Brought to the Clinic by Her

question 694

Multiple Choice

A 6-year-old girl is brought to the clinic by her parents after multiple falls while running in the past few months.  Over the past month, the patient has also had intermittent headaches, with increased frequency in the past 2 weeks.  The headaches are worse in the morning and have occasionally been accompanied by nausea and vomiting.  Examination shows a tired-appearing young girl.  The patient walks with a wide-based gait and has difficulty with heel-to-toe walking.  Eye examination reveals bilateral abducens nerve palsies and papilledema.  The remainder of the cranial nerve examination is normal.  Strength is 5/5 in bilateral upper and lower extremities.  Sensation is intact, and reflexes are 2+ bilaterally.  Babinski testing reveals plantar flexion of the toes.  Which of the following is most likely responsible for this patient's symptoms?

• A)Acoustic neuroma
• B)Craniopharyngioma
• C)Glioblastoma
• D)Medulloblastoma
• E)Meningioma
• F)Pinealoma

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