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Balloon Angioplasty

Medulloblastoma (muh-DUL-oh-blas-TOE-muh) is a malignant (cancerous) brain tumor that begins in the cerebellum, the lower back part of the brain responsible for balance, coordination and movement. Medulloblastoma starts as a fast-growing mass of abnormal cells. These cells can spread within the brain and spinal cord through the fluid that surrounds them, called cerebrospinal fluid (CSF). Unlike many other cancers, medulloblastoma rarely spreads outside the brain and spinal cord. Although medulloblastoma can occur at any age, it is most common in young children. It is rare overall, but it is the most common malignant brain tumor in children. The risk is higher in families with certain inherited cancer-predisposition syndromes, such as Gorlin syndrome or Turcot syndrome. Symptoms Symptoms usually develop as the tumor grows or increases pressure inside the brain. Common signs and symptoms include: Headaches, often worse in the morning Nausea and vomiting Dizziness Double vision Poor coordination or clumsiness Unsteady walking Tiredness or weakness When to see a doctor Make an appointment with a healthcare professional if you or your child has symptoms that are persistent, worsening, or concerning. Causes The exact cause of medulloblastoma is not fully understood. Medulloblastoma develops when brain cells acquire changes in their DNA. DNA contains instructions that control how cells grow, divide and die. In healthy cells, these processes are tightly regulated. In cancer cells, DNA changes cause the cells to multiply rapidly and avoid normal cell death. As these abnormal cells accumulate, they form a tumor that can press on nearby brain structures, invade healthy tissue, and spread through the cerebrospinal fluid to other parts of the brain and spinal cord. Risk Factors Factors that may increase the risk of medulloblastoma include: Young age – most cases occur in children Inherited genetic syndromes that increase cancer risk, including: Fanconi anemia Gorlin syndrome Li-Fraumeni syndrome Rubinstein-Taybi syndrome Turcot syndrome Key Points to Know Medulloblastoma is aggressive but highly treatable, especially when diagnosed early Treatment often involves a combination of surgery, radiation therapy and chemotherapy Outcomes have improved significantly due to advances in pediatric neuro-oncology Early diagnosis, specialized care and long-term follow-up are essential for the best possible outcomes.

What Is a Cerebral Arteriovenous Fistula? A cerebral arteriovenous fistula (AVF) is an abnormal direct connection between an artery and a vein in the brain. How Normal Blood Flow Works In a healthy circulatory system: Blood flows from arteries → capillaries → veins Capillaries slow blood flow so oxygen and nutrients can be delivered to brain tissue Veins then carry blood back to the heart What Happens in an AVF In a cerebral AVF: Blood bypasses the capillaries Blood flows directly from an artery into a vein This causes high-pressure arterial blood to enter veins that are not designed to handle it Over time, this abnormal circulation can: Reduce oxygen delivery to brain tissue Increase pressure inside veins Raise the risk of bleeding and neurological damage Cerebral AVFs may be congenital (present at birth) or acquired later in life. Symptoms of a Cerebral Arteriovenous Fistula Symptoms vary depending on the size, location, and blood flow of the AVF. Some people have no symptoms initially, while others develop serious complications. Common symptoms include: Hemorrhagic stroke due to bleeding in the brain Sudden severe headache Weakness or numbness Difficulty speaking or moving Seizures Pulsatile tinnitus (a rhythmic “whooshing” sound in the ear) Audible bruit (a sound caused by turbulent blood flow) Neck or back pain Neurological deficits depending on the affected brain area Symptoms can worsen suddenly if bleeding occurs, which is a medical emergency. Causes of Cerebral Arteriovenous Fistulas Cerebral AVFs can develop for several reasons: Congenital Causes Abnormal blood vessel development during fetal growth Present at birth, though symptoms may appear later Acquired Causes Trauma (e.g., head injury, gunshot or stab wounds) Surgical or medical procedures involving blood vessels Vascular conditions, such as aneurysms or other malformations Spontaneous formation, especially in older adults Note: AVFs created surgically for dialysis are intentional and occur outside the brain. Cerebral AVFs are abnormal and potentially dangerous. Complications and Related Conditions If left untreated, a cerebral AVF can lead to serious complications: Brain Bleeding (Intracranial Hemorrhage) Veins exposed to high arterial pressure may rupture Can cause stroke, brain damage, coma or death Seizures Caused by irritation of brain tissue from abnormal blood flow or bleeding Heart Strain and Heart Failure Large AVFs force the heart to pump harder Over time, this can lead to high-output heart failure Blood Clots Turbulent blood flow increases clot formation Can result in deep vein thrombosis (DVT) or pulmonary embolism