James is 5 years old and has had worsening headaches for several weeks. He awakens with repeated vomiting. His parents rush him to the emergency room where he has a generalized seizure. A computerized tomography (CT) scan shows a posterior fossa tumor and hydrocephalus. He is admitted to the hospital and an emergency ventriculoperitoneal shunt is placed. Magnetic resonance imaging (MRI) confirms a likely medulloblastoma. In discussion with oncology, parents ask about future effects of treatment for the tumor.