14-Year-Old Male Patient Admitted with Left Visual Loss and Altered Level of Consciousness

Gabriela de Toledo Passos Candelaria, M.D.
Rio de Janeiro, Brazil

Case Summary

  • 14-year-old, male, born and raised in São Paulo, Brazil.
  • Previously healthy.
  • Admitted to E.R. with left vision loss and altered level of consciousness.
  • Recurrent episodes of headaches during the past 30 days, blurred vision, and poor balance.

Successful endotracheal intubation performed and a CT was ordered.

Infratentorial mass, with partially defined limits, occupying the fourth ventricle and measuring 6.1 x 5.6 x 5.5 cm.

  • Consider Embryonic Tumors (e.g., medulloblastoma, atypical rhabdoid teratoid tumor)
  • Resection of the mass
    • Pathology Report: Classic Medulloblastoma (WHO Grade IV) - Beta catenin +


  • Good progress, extubated.
  • Maintained blurred vision.
  • Was discharged from ICU
  • Partial vision loss
  • Grade 4 muscle weakness
  • No complaints or bleeding


Anticoagulation using Low Molecular Weight Heparin (LMWH):

  • Enoxaparin 1mg/kg/dose q12h


  • Hb=10.8 / Hct=31.2 / WBC=11360 / Plt=264k
  • Fibrinogen = 313
  • aPTT= 23.1s / R=0.8
  • PT=13s / Prothrombin activity= 88%
  • D-Dimer=5238


Patient Case Video

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