Brain Stem Gliomas pathophysiology

Brain Stem Gliomas Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Pathophysiology

The brain stem gliomas are classified into 4 subtypes, and each has its distinct histological features:

• Diffuse brainstem gliomas
  • Usually fibrillary astrocytomas
  • WHO grades II-IV
  • Grade does not impact on prognosis, and thus biopsy is usually not necessary
• 75% of brain stem gliomas
• Focal glioma
  • Fibrillary astrocytoma (grade II): most common histology
  • Pilocytic astrocytoma
  • Ganglioglioma
• (Dorsally) exophytic glioma
  • Low grade astrocytoma
  • Ganglioglioma
• NF1-associated brainstem glioma
  • Seen in up to 9% of NF1 patients
  • Most frequently seen in the medulla
  • Appears similar to a sporadic focal brainstem glioma but has an even better prognosis, with little if any progression