Diffuse pontine glioma

Case contributed by Dr Shankar Poudel

Presentation

Headache.

Patient Data

Age: 7 years
Gender: Male
MRI

Pons is diffusely bulky and non-enhancing, displacing basilar artery anteriorly, compressing fourth ventricle posteriorly and exhibits T1 hypointense and T2 hyperintense signal. 

On DWI, no diffusion restriction noted, thus differentiating this from acute pontine infarction.

On MRS, there is increased choline:creatinine ratio measuring 3.2.

Case Discussion

Diagnosis is most likely of diffuse pontine glioma, however, no histological proof is available.

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