<prompt> Long term effect of craniospinal irradiation for medulloblastoma is :Secondary malignancyNeuro endocrine abnormalitiesNeurocognitive effectsHearing loss  <response>: Craniospinal Irradiation Hypothyroidism: One of the earliest late side effects of CSI and 2nd MC after GH disturbance Prevelence of hypothyroidism is 40-80 after CSI Significantly increased risk of development of benign thyroid nodules and papillary carcinoma of the thyroid many years later Ref: 