Dr. med. Özlem Kiran, Istanbul, Turkey
Brain stem gliomas are tumors that occur in the region of the brain referred as brain stem, which is the area between the sylvian aqueduct and the fourth ventricle. The literature divides brain stem gliomas into three distinct anatomic locations: diffuse intrinsic pontine, tectal and cervicomedullary. Intrinsic pontine gliomas carry a grave prognosis. Longer survival is associated with the tectal and cervicomedullary gliomas.
These tumors have a predilection to originate from the left side. Most are located in the pons; however medulla and midbrain may be involved as well. Brain stem gliomas are highly aggressive brain tumors. Anatomic location determines the pathophysiological manifestation of the tumor. With tectal lesions, hydrocephalus may occur as a result of fourth ventricular compression, With pontine and cervicomedullary lesions, cranial nerve or long tract signs are observed commonly.