The value of myelography in the management of childhood medulloblastoma.

Sixteen children with newly diagnosed medulloblastomas underwent myelography prior to radiotherapy. None had clinical evidence suggesting spinal cord involvement. Seven patients (43%) were discovered to have unsuspected metastases involving the cord. Cerebrospinal fluid (CSF) cytology results were inaccurate in predicting spinal cord involvement. Additional radiation was administered to the demonstrated lesions. Thirteen children (81%) are alive and well 7-53 months (average 26) from completion of therapy. One of nine children with a normal myelogram initially, and two of seven with initial spinal cord involvement have relapsed.