title: Cauda equina syndrome as the initial presenting clinical feature of medulloblastoma: a case report.
abstract: BACKGROUND
  Medulloblastoma is one of the most common pediatric brain malignancies. The usual presenting clinical features are related to posterior fossa syndrome or/and hydrocephalus. Cauda equina syndrome is a very rare presentation for this disease.
  
  
  METHODS
  We describe the case of a three-year-old boy with cauda equina syndrome as the initial presenting clinical feature for medulloblastoma. He was initially diagnosed as having a spinal tumor by magnetic resonance imaging scan. Subsequently, a cranial magnetic resonance imaging scan revealed a posterior fossa tumor with features of dissemination. He had substantial improvement after treatment. This case report is complemented by a literature review related to this unusual presentation.
  
  
  CONCLUSIONS
  Medulloblastoma primarily presenting with cauda equina syndrome is very rare. However, spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management.
authors.affiliation: Division of Neurosurgery, Neurosciences Department, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh, 11211, Saudi Arabia. faisalruwais@gmail.com.
authors.forename: Faisal
authors.initials: F
authors.lastname: Al-Otaibi
authors.forename: Anwar
authors.initials: A
authors.lastname: Ul-Haq
authors.forename: Hindi
authors.initials: H
authors.lastname: Al-Hindi
authors.forename: Amani
authors.initials: A
authors.lastname: Al Kofide
authors.forename: Essam
authors.initials: E
authors.lastname: Al Shail