Morning Headache and Ocular Pain in a 16-year-old male patient: A Case of Medulloblastoma Presenting with Papilledema

Abstract

Headache is a common complaint in primary care; however, when it is associated with ocular pain and morning aggravation, it warrants evaluation for increased intracranial pressure (ICP). A 16-year-old male presented with a one-month history of constant headache and ocular pain, worse in the morning and exacerbated by bending forward. He complained of nausea but no vomiting. Ophthalmic examination showed a best-corrected visual acuity (BCVA) of 0.7 in both eyes, alternating exotropia, and normal intraocular pressure. Fundoscopy indicated bilateral optic disc edema. Visual field testing proved enlargement of the blind spot. Neuroimaging via MRI showed a posterior fossa mass, later diagnosed as medulloblastoma. This case demonstrates the pivotal role of a thorough history and ophthalmic examination in diagnosing medulloblastoma presenting with papilledema. In young patients with headache and signs of increased ICP, prompt neuroimaging is critical to rule out malignancy.

Keywords: Medulloblastoma, Papilledema, Fundoscopy, Intracranial pressure, Posterior fossa tumor