BRAIN-STEM GLIOMA .1. PATHOLOGY, CLINICAL-FEATURES, AND THERAPY

Gliomas that arise in the brain stem have been associated with a poor prognosis. Diagnostic neuroimaging readily identifies the tumor as it extends between normal brainstem structures. Histologic sampling of tu mor with stereotactic methods is notoriously unreliable in establishin g a definitive prognosis. Clinical trials that incorporate high-dose c hemotherapy, autologous bone marrow rescue, and irradiation hold promi se of better tumor control by overcoming the inaccessibility of the ce ntral nervous system to standard doses of chemotherapy. We review the pathology, clinical features, neuroimaging features, and current thera peutic concepts relative to brainstem glioma. The pediatric neurologis t has a pivotal role in identifying and monitoring children with this malignancy.