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Supratentorial PNET



Signs and Symptoms

There is usually a short history of symptoms as these tumors are rapidly growing.

Children may present with:

  • Signs and symptoms of raised intracranial pressure
  • Localizing signs
  • Non-localizing signs


General Overview of Supratentorial PNET Presentation:


Possible Presentation

Raised intracranial pressure

Headache, vomiting, lethargy

Papilledema - with swelling and hemorrhage of the optic disc on fundoscopy:


Cranial nerve abnormalities:


The most commonly 6th (VI) - cranial nerve:


This is a "false localizing sign".


Hydrocephalus causes compression of the 6th cranial nerve at the petroclival ligament, resulting in diplopia, medial deviation of the affected eye and lateral gaze paresis.


Left lateral rectus (6th cranial nerve palsy)

Localizing symptoms and signs due to tumor infiltration into normal structures

Supratentorial brain:

  • Hemiparesis/limb weakness from cerebral cortex involvement
  • Hemisensory loss
  • Visual field abnormalities
  • Cognitive/learning difficulties
  • Seizures

Deep midline tumors:

  • Endocrinopathies
  • Visual acuity and visual field abnormalities
  • Parinaud’s syndrome due to compression of the pre-tectal area (paralysis of upgaze, loss of pupillary reflex to light, eyelid retraction and nystagmus)
Non-localizing symptoms and signs


General malaise

Changes in behavior

Loss of previously acquired developmental milestones








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