Physical Examination 
• Complete neurologic examination. 
• Evaluation for optic tract glioma includes neuro-ophthalmological testing, including visual fields. Subtle 
  changes in the tumor that may not be apparent with CT or MRI scanning can be measured in this way. Young 
  children may have a test called visual-evoked response for diagnosis and follow-up.

Blood and Other Tests 
• Bone marrow may be analyzed for tumors that spread outside the central nervous system (medulloblastoma).
• For tumors that may spread to the spinal cord or through the cerebrospinal fluid (medulloblastoma , 
  ependymoma, intracranial germ cell tumors, pineal tumors, cerebral neuroblastoma—PNET), spinal fluid 
  should be examined for malignant cells.
• For intracranial germ cell tumors, tumor markers including alpha-fetoprotein (AFP) and human chorionic 
  gonadotropin (HCG) are measured in the blood and cerebrospinal fluid. The same markers are also measured in 
  pineal tumors to exclude the possibility of a malignant germ cell tumor.