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

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 +

CLINICAL PROGRESS

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

TREATMENT

Anticoagulation using Low Molecular Weight Heparin (LMWH):

• Enoxaparin 1mg/kg/dose q12h

LAB RESULTS:

• 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