Gliomas of the anterior visual pathways

Gliomas of the anterior visual pathways include the more commonly encountered benign tumors of children and the rare and highly aggressive malignant tumors of adults. Diagnostic biopsy is not required in most cases of childhood gliomas, especially those unassociated with visual loss or other neurologic symptoms, because the clinical and neuroimaging features are often sufficiently characteristic. Because of the infiltrative nature of these tumors, the neurosurgeon has little to offer symptomatic patients beyond debulking large exophytic masses and shunting if hydrocephalus is present.