Brain Stem Gliomas classification

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

Overview

Brainstem gliomas may be classified into four subtypes: diffuse, focal, dorsal exophytic, and cervicomedullary.

Classification

Brainstem gliomas

Diffuse brainstem glioma

Focal brainstem glioma

exophytic

Cervicomedullary

Brainstem gliomas may be classified into 4 subtypes:

• Diffuse brainstem glioma
• Focal brainstem glioma
  • Tectal plate glioma
  • Other focal gliomas
• (Dorsally) exophytic
• Cervicomedullary
  • Probably an artificial group made up of the downward extension of true brainstem gliomas or upward extension of upper cervical cord intramedullary spinal cord tumors.

Brainstem gliomas

Diffuse brainstem glioma

Focal brainstem glioma

exophytic

Cervicomedullary

References

Diseases	Symptoms					Physical Examination				Diagnostic tests			Past medical history	Other Findings
	Hematuria	Pyuria	Frequency	Urgency	Dysuria	Fever	Tenderness	Discharge	Inguinal Lymphadenopathy	Urinalysis	Urine Culture	Gold Standard
Differentiating amongst different types of urinary tract infections:
Pyelonephritis	+	+	–	–	+	+	Flank or costovertebral angle	+	+	Leukocytes Nitrite +ve	Identifies causative bacteria	Urine culture	History of pyelonephritis Recent history of hospitalisation Nephrolithiasis Immunosupression	Costovertebral angle tenderness Patient is in acute distress Look for obstructive causes
Cystitis	+	+	+	+	+	+	Suprapubic	–	+	Nitrite +ve Leukocyte esterase +ve WBCs RBCs	>100,000CFU/mL	Urine culture	Recent catheterisation Pregnancy Recent intercourse Diabetes Personal or family history of UTI Known abnormality of the urinary tract BPH HIV	Imaging studies help differentiate the various types May accompany back pain, nausea, vomiting, and chills
Urethritis	–	+	–	–	+	+	–	Urethral discharge	+	Positive leukocyte esterase test or >10 WBCs Mucous threads in the morning urine	–	Gram stain & mucoid or purulent discharge	Prior STDs Urinary tract infections New sexual partner Recent intercourse Recent catheterization	Purulent discharge may suggest gonorrhoea Exclusive dysuria suggest Chlamydia Painful genital ulcers with dysuria suggest HSV
Prostatitis	–	+	+	+	+	+	–	–	–	10–20 leukocytes for acute and chronic bacterial subtypes	Identifies causative bacteria (in bacterial subtypes)	Urine culture	Urogenital disorders Recent catheterization or other genitourinary instrumentation History of UTIs	Tender and enlarged prostate in acute prostatitis[1][3] Tender and soft (boggy) prostate in chronic prostatitis[1] A prostate massage should never be done in a patient with suspected acute prostatitis, since it may induce sepsis.
Diseases	Symptoms					Physical Examination				Diagnostic tests			Past medical history	Other Findings
	Hematuria	Pyuria	Frequency	Urgency	Dysuria	Fever	Tenderness	Discharge	Inguinal Lymphadenopathy	Urinalysis	Urine Culture	Gold Standard