‘Sam’ was a six-year-old boy with medulloblastoma causing obstructive hydrocephalus and ataxia. Surgery, rehabilitation and possible long-term disability or neurological deficit were prepared for thoroughly by Sam and his family with the help of a multidisciplinary team. Full resection was successful but was followed by posterior fossa syndrome. His parents, who were under great stress throughout, were encouraged to communicate their concerns in a designated environment and to assist in their child’s rehabilitation. A care plan ensured that they were involved with, but not overwhelmed by, his needs and the long-term prognosis.