Diffuse brainstem glioma

Case contributed by Huda B. Gharbia
Diagnosis probable


Headache, unsteady gait and blurred vision.

Patient Data

Age: 10 years
Gender: Male

There is enlargement of brainstem mainly pons and lesser degree midbrain, which appears heterogeneously hypointense on T1W and hyperintense on both T2W and FLAIR sequences. It shows areas of mild enhancement on T1W post contrast.

It causes mass effect in the form of effacement of the prepontine cistern, displacing and partially encasing the basilar artery anteriorly, flattening the fourth ventricle posteriorly and obliteration of perimesencephalic cisterns laterally.

Case Discussion

Expanded brainstem, mainly pons, which appears hyperintense on both T2W and FLAIR sequences, with significant mass effect and flat fourth ventricle sign are suggestive features of diffuse brainstem glioma.

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