Roger J Packer MD, contributing editor. Dr. Packer of the Children's National Medical Center and George Washington University has no relevant financial relationships to disclose.
Publication dates
Originally released October 14, 1996; last updated September 5, 2012; expires September 5, 2015
• Brainstem gliomas occur most frequently in children, with the majority being diffuse pontine gliomas.
• Approximately 20% of childhood brainstem gliomas are not diffuse pontine tumors; these non-diffuse pontine lesions, such as tectal gliomas and exophytic cervicomedullary tumors, are often low-grade gliomas and have a relatively good prognosis.
• Over 90% of children with diffuse pontine gliomas will die of disease within 18 months of diagnosis.
• Radiotherapy remains the only effective, albeit transient, therapy for diffuse pontine gliomas.
Historical note and nomenclature
Brainstem gliomas are, by definition, glial tumors that primarily arise within the brainstem. Concepts concerning brainstem gliomas have changed remarkably since the advent of MRI. Although the majority of brainstem gliomas arise in the pons, subsets of patients have been identified with more caudal or rostral tumors (Packer et al 1993a; 1993b). In addition, MR has more clearly identified the extent of lesions and the tendency of some brainstem tumors to infiltrate the diencephalon, the cervical cord, and even the cerebellum (Barkovich et al 1991).
