Review the radiological findings in CT andMR in patients diagnosed with brainsterm diffuse glioma.

Brainstem diffuse gliomas have a poor prognosis and is important to recognize their image findings. These tumors are infiltrating astrocitomas, and most frequently arise in the pons, typically present in childhood (3 to 10 years of age) and make up 10 - 15% of all paedriatric brain tumors and 20 - 30% of paedriatric posterior fossa tumors. Typically patients present with multiple cranial nerve palsies and signs of raised intracranial pressure.Cerebellar signs may also be elicited including ataxia, dysarthria, nystagmus and sleep apnoea. These tumours...

The pons is enlarged Fig. 1,with the basilar artery are displaced anteriorly against the clivus and potentially engulfed Fig. 6.The floor of the fourth ventricle is flattened Fig. 5 and obstructive hydrocephalus may be present. Occasionally the tumour is exophytic Fig. 6, either outwards into the basal cisterns or centrally in the 4 ventricle. Usually the tumour is homogenous pre-treatment, however in a minority of patients areas of necrosis may be present. The findings in CT:Typically hypodense Fig. 4, with little if any enhancement and...

Diffuse brainstem gliomas are infiltrating astrocytomas, and most frequently arise in the pons. These tumours presents in childhood (3 to 10 years of age).Symtoms are cranial nerve palsies and signs of raised intracranial pressure. In the sporadic form the prognosis is poor with 2 year survival being only 20% (median survival less than 1 year). Typically findings are hipodense lesions at CT, decreased intensity in T1, heterogeneously increased at T2, usually minimal enhanced in T1 Contrast.

1. Barkovich AJ. Pediatric neuroimaging. Lippincott Williams & Wilkins. (2005) ISBN:0781757665. 2. Koeller KK, Rushing EJ. From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics. 24 (6): 1693-708. 3. Nelson MD, Soni D, Baram TZ. Necrosis in pontine gliomas: radiation induced or natural history? Radiology. 1994;191 (1): 279-82. 4. Helton KJ, Phillips NS, Khan RB et-al. Diffusion tensor imaging of tract involvement in children with pontine tumors. AJNR Am J Neuroradiol. 2006;27 (4): 786-93. 5. Keating RF, Goodrich JT, Packer RJ. Tumors of...