The yearly incidence of brain tumours in Sweden during 1984–2005 was 4.2/100,000 in children younger than 15 years [
1]. Survival rates have improved but vary across different tumour types [
2]. There is also variation regarding long-term complications, including neurological and endocrinological dysfunction, as well as cognitive and psychological difficulties [
3,
4]. This may be caused by the tumour itself or by the treatment given (surgery, irradiation and/or cytotoxic drugs) [
5]. Complications are mainly reported among children treated for high-grade tumours [
6], but in an earlier study we found physical and cognitive complications among children treated not only for high-grade but also for low-grade tumours [
7]. The tumour location plays a role in that infratentorial tumours are described to have a worse prognosis compared with supratentorial tumours, especially regarding cognitive and social-emotional functioning [
8]. This may be explained by the role of the cerebellum in coordinating motor function and cognition [
9]. Studies using functional MRI have shown that the cerebellum coordinates executive functions and working memory in neural networks. Injuries may affect executive function, spatial cognition, personality and language [
9] as well as fine-motor skills, most obvious in complex activities [
10]. Children treated for tumours in the posterior fossa also perform worse in tests of gross-motor functions, especially when performing balance tasks [
11]. A cerebellar cognitive affective syndrome has been described, characterised by deficits in executive function, spatial cognition, linguistic processing and affect regulation [
12]. Difficulties are reported for all children treated for tumours in the posterior fossa, but more pronounced in children treated with both surgery and radiation [
10].
Pilocytic astrocytoma is the most common brain tumour type in childhood located in the posterior fossa, and is mainly treated with surgery [
13,
14]. These tumours have low mortality, and the long-term functional outcome is described as favourable [
15‐
17]. Although there are studies describing neurological, cognitive, emotional and behavioural complications among these patients there is still a lack of knowledge concerning the long-term outcome for this population [
18‐
24].
Against this background of ambiguous results concerning the long-term functional outcome for children treated for low-grade pilocytic astrocytoma, the aim of this descriptive study was to investigate whether patients had long-term complications affecting physical and psychological health, cognitive functions and quality of life. We also wanted to investigate if this affected the psychosocial and educational situation for young adults and whether learning difficulties had been observed in school and had led to increased educational support. Our hypothesis was that some of the patients have long- term complications, affecting physical and psychological health, cognitive functions including learning abilities, and quality of life.