Brain Stem Gliomas overview

Jump to navigation Jump to search

Brain Stem Gliomas Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Brain Stem Gliomas from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Brain Stem Gliomas overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Brain Stem Gliomas overview

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Brain Stem Gliomas overview

CDC on Brain Stem Gliomas overview

Brain Stem Gliomas overview in the news

Blogs on Brain Stem Gliomas overview

Directions to Hospitals Treating Brain Stem Gliomas

Risk calculators and risk factors for Brain Stem Gliomas overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Brainstem gliomas are tumors that occur in the region of the brain referred to as the brain stem, which is the area between the aqueduct of Sylvius and the fourth ventricle.

Historical prospective

In the era preceding modern imaging, all brainstem gliomas were regarded as a solitary pathological entity with poor prognosis. In the late 1960s, Matson suggested that all brainstem tumors were malignant and were deemed inoperable regardless of their histopathological characteristics or location.This assertion was questioned shortly thereafter by Pool, who was one of the first to report tumor resection in the brainstem, which in the case described was inside the aqueduct. In 1980, Hoffman et. described the dorsally exophytic group of brainstem gliomas as a distinct subgroup, and reported that these lesions were surgically curable with aggressive resection. Over the past 3 decades, the treatment of brainstem gliomas has notably progressed as a result of the gradual advancements in microsurgical techniques, sophisticated imaging technology and, most importantly, the availability of MRI. These modalities have revealed that brainstem gliomas are a heterogeneous group of tumors.

Classification

Brainstem gliomas may be classified into four subtypes: diffuse, focal, dorsal exophytic, and cervicomedullary.

Pathophysiology

On gross pathology, brainstem gliomas can be classified into four subtypes: diffuse, focal, dorsal exophytic and cervicomedullary. Each of the four subtypes has its distinct microscopic pathology. Genes involved in the pathogenesis of diffuse intrinsic pontine gliomas include Histone H3, ACVR1, PDGFRA, and TP53.

Epidemiology and Demographics

The incidence of brainstem gliomas is estimated to be 0.05 - 0.1 cases per 100,000 individuals in the USA. A bimodal distribution by age is noted with peak incidences rates in children and older adults. The prevalence and incidence of brainstem gliomas do not vary by either race or gender.

References

Template:WH Template:WS