Brainstem Glioma

  • Etiology: heterogeneous group of tumors
  • Imaging: anterior to fourth ventricle, can be tectal / ventral pons / dorsal pons / medulla, usually infiltrative, irregular enhancement (50%), can be exophytic and encase basilar artery, occasionally cystic
  • DDX: granuloma, rhomboencephalitis, infarction, cryptic vascular malformation, demyelination, metastasis, radiation effect
  • Complications:
  • Treatment: non-resectable
  • Clinical: cranial nerve palsy

Radiology Cases of Brainstem Glioma

MRI of brainstem glioma
Sagittal T1 MRI without contrast of the brain (above left) shows a large mass expanding the entire brainstem. Axial T2 (above right) and axial FLAIR (below left) MRI show the mass to be somewhat heterogenous and the mass has multiple foci of enhancement on the axial T1 MRI with contrast (below right).