Presentation
Right hemiparesis.
Patient Data
There is well circumscribed mass centered in the pons and extending into the left middle cerebellar peduncle. It measures 47 x 42 x 38 mm in its widest dimensions. The mass appears predominantly hypointense on T1 and hyperintense on T2, with no evidence of diffusion restriction. It shows minimal patchy heterogeneous enhancement on T1 with gadolinium contrast. There is an intralesional cystic component in its posterior part. No booming artifact is seen on Gradient echo sequence.
There is associated effacement of the fourth ventricle and the prepontine cistern. The mass also compresses the basilar artery.
No supratentorial hydrocephalus is seen.
Case Discussion
The pons is the most common location for brainstem gliomas. It occurs commonly in the first decade of life. These MRI findings are in keeping with a pontine glioma in a child who presented with right hemiparesis.