Brainstem glioma

Case contributed by Dr Hani Salam


Bulbar palsies and headache.

Patient Data

Age: 10 years
Gender: Female

CT brain

Non-contrast CT of the brain demonstrates a large heterogenous mass expanding the pons, distorting the fourth ventricle and resulting in a degree of hydrocephalus. The mass is predominantly hypoattenuating centrally, with a region of relative hyperattenuation peripherally on the left. 


MRI brain

MRI of the brain confirms the presence of a large mass expanding the pons. It is T1W hypointense and T2W hyperintense, with areas on the left which demonstrate fluid signal intensity and mostly attenuated on FLAIR.  These areas also demonstrate peripheral irregular contrast enhancement. The mass overall does not demonstrate restricted diffusion, nor are there convincing areas of calcification or hemorrhage on gradient echo. 

The fourth ventricle is effaced and hydrocephalus is present. 

Case Discussion

This case is typical of a high grade diffuse brainstem glioma. In many centers when features are typical, no biopsy is carried out, as biopsies of the brainstem have high morbidity, and histological confirmation often has little impact on treatment. 

PlayAdd to Share

Case information

rID: 9444
Published: 19th Apr 2010
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.