Brainstem glioma: an analysis of 85 cases

The study analyses 85 cases of brainstem glioma in the past 35 years, 69 of which include patients under 16 years of age. The incidence of brainstem glioma was 2.4% of all intracranial tumours, and 9.4% of intracranial tumours in children. There were two peaks in age distribution, in the first and in the fourth decades. In children, the tumours were located mainly in the pons, so VIth and VIIth cranial nerve palsies, and pyramidal and cerebellar signs were frequently seen. In adult cases, the tumours ranged in location from the midbrain to the medulla, so neurological symptoms caused by lesions of the whole brainstem axis were seen. The left side was dominant in both age groups. The choice of treatment was steroid administration and radiation. Chemotherapy was not effective. Even after these treatments, the median survival period from onset was no longer than 10.5 months. We conclude that the treatment of brainstem gliomas in children should be distinguished from adult cases, which in the latter may be considered to be merely one of the gliomas which may occur at any other sites. Since brainstem gliomas in children may be congenital, we must redirect our treatment of these lesions to treatment of congenital tumours.