Surgical Treatment of Brainstem Gliomas in Children

Roonprapunt, Chan; Abbott, Rick

doi:10.1097/00013414-200206000-00008

Cited by 7 publications

(9 citation statements)

References 58 publications

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“…[31] Most commonly seen in the midbrain or medulla, they may occur anywhere in the brainstem [Figure 5]. They have distinct borders on the MRI, whether solid or cystic.…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

“…Radiographic findings and clinical correlates can be used to categorize brain stem tumors into four types: diffuse, focal, exophytic and cervicomedullary. [ 31 ] Histologically, most brain stem gliomas are fibrillary astrocytomas (80%), compared to cerebellar astrocytomas which are predominantly pilocytic. Uncommon tumors include subependymomas, lymphomas, gangliogliomas, and oligodendroglioma.…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

“…Roonprapunt and Abbot have suggested a treatment algorithm for the initial surgical workup of brain stem gliomas. [ 31 ]…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

“…Diffuse brain stem gliomas are the most commonly seen tumor in the brain stem, accounting for between 58% and 75% of all gliomas in this area. [ 31 ] Seen as hypointense lesions in T1-weighted images, generally greater than 2 cm in size, centered around and expanding the pons, they are associated with significant edema seen in the corresponding T2-weighted images [ Figure 4 ]. Gadolinium enhancement may be variable and has no prognostic implication.…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

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Management of posterior fossa gliomas in children

Sridhar

Venkatprasanna

2011

J Pediatr Neurosci

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Brain tumours form the most common type of solid tumour in children and more that 50% of these are infratentorial. Cerebellar astrocytomas and brain stem gliomas are the commonest posterior fossa glial tumours in children. Cerebellar astrocytomas represent up to 10% of all primary brain tumours and up to 25% of posterior fossa tumors in children, with Low grade gliomas forming the commonest of the cerebellar gliomas. They commonly present with symptoms and signs of raised intracranial pressure due to obstructive hydrocephalus. Radiologically they may be solid or cystic with or without a mural nodule. Surgical excision is the mainstay of treatment and forms the most consistent factor influencing progression free and long term survival. While majority of the tumours are pilocytic astrocytomas, they may also be fibrillary astrocytomas or even high grade tumours. Tumour histology does not appear to be an independent factor in the prognosis of these children, and therefore no palliative treatment after surgery is advocated. Brain stem gliomas account for approximately 10% of all pediatric brain tumours. Cranial nerve signs, ataxia and cerebellar signs with or without symptoms and signs of raised intracranial pressure are classically described symptoms and signs. Radiographic findings and clinical correlates can be used to categorize brain stem tumours into four types: diffuse, focal, exophytic and cervicomedullary. Histologically most brain stem gliomas are fibrillary astrocytomas. Diffuse brain stem gliomas are the most commonly seen tumour in the brain stem. These lesions are malignant high grade fibrillary astrocytomas. Focal tumours of the brain stem are demarcated lesions generally less than 2 cms in size, without associated edema. Most commonly seen in the midbrain or medulla, they form a heterogeneous pathological group, showing indolent growth except when the lesion is a PNET. Dorsally exophytic tumours lie in the fourth ventricle, while cervicomedullary lesions are similar to spinal intramedullary tumours. Expanding lesions are the only lesions amenable for excision while infiltrative and ventral lesions are not.

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“…[31] Most commonly seen in the midbrain or medulla, they may occur anywhere in the brainstem [Figure 5]. They have distinct borders on the MRI, whether solid or cystic.…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

“…Roonprapunt and Abbot have suggested a treatment algorithm for the initial surgical workup of brain stem gliomas. [ 31 ]…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

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Management of posterior fossa gliomas in children

Sridhar

Venkatprasanna

2011

J Pediatr Neurosci

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“…B rainstem gliomas have historically been considered surgically inoperable, although magnetic resonance imaging (MRI) and stereotactic techniques have advanced the treatment of these lesions (20,32). Approximately 300 new cases are diagnosed yearly in the United States (36); about 70% of these cases are diffuse pontine gliomas (13).…”

mentioning

confidence: 99%

A Surgical Technique for Safely Placing a Drug Delivery Catheter into the Pons of Primates: Preliminary Results of Carboplatin Infusion

Storm¹,

Clatterbuck²,

Liu³

et al. 2003

Neurosurgery

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The pons of monkeys is safely accessed with a catheter for drug delivery by using a posterior midline approach. Clinical observations, radiographic imaging, and laboratory tests of animals infused with saline for 3 months or 0.26 mg/ml of carboplatin for 1 month were unremarkable. Neurotoxicity was seen with dose levels of 2.6 mg/ml of drug for 1 month. This procedure offers opportunities for examining the toxicity of brainstem antitumor therapy in primates.

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