Brainstem glioma associated NF1

Case contributed by Huda B. Gharbia
Diagnosis almost certain


Known case NF1, with family history of NF1, presented with ataxia,dysarthria, bulbar palsy.

Patient Data

Age: 9 years
Gender: Female

There is diffuse enlargement of brainstem, (midbrain, pons and  more prominent in medulla oblongata), involving cervico-medullary junction, which appears hyperintense in T2W and FLAIR sequences, and shows no enhancement in T1W post contrast.

Also noted bilateral symmetrical hyperintense foci in both T2W and FLAIR sequences in basal ganglia, middle cerebellar peduncles, dentate nuclei, and show no contrast enhancement.

Case Discussion

Diffuse brainstem enlargement and hyperintensity in T2W and FLAIR sequences, centered on medulla oblongata, involving the cervicomedullary junction, suggestive of brainstem glioma associated NF1.

Multiple focal areas of hyperintensity in basal ganglia, middle cerebellar peduncles, dentate nuclei, suggestive central nervous system manifestations of NF1.

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