Cite

Copy

Tap on and choose 'Add to Home Screen' to create a shortcut app

Tap on and choose 'Install/Install App' to create a shortcut app

Management of Brainstem Gliomas in Children

This page was last updated on May 9th, 2017

Initial Management at Presentation

  • Categorization of tumor: Since treatment varies with tumor type, the first step in management of a brainstem glioma is to categorize it as a focal, exophytic, diffuse, or cervicomedullary tumor.
  • Focal, exophytic, and cervicomedullary tumors: These tumors can be managed initially with surgery. They all share the feature that treatment tolerance is a function of the clinical state of the patient. Therapy is best tolerated by a patient with minimal or no symptoms or signs of neurological dysfunction. Therefore, treatment is best initiated at the time of the tumor’s discovery.
  • Diffuse intrinsic pontine glioma: Patients with diffuse intrinsic pontine gliomas should be evaluated by the oncology team for radiation therapy, with or without adjuvant chemotherapy.

Adjunctive Therapies

  • Diffuse intrinsic pontine glioma: Patients with diffuse intrinsic pontine gliomas may receive chemotherapy before, concomitant with, or after radiation therapy. To date, however, chemotherapy has no proven efficacy.

Follow-up

  • Schedule dictated by expectations of tumor behavior: Beyond the standard postoperative visits, follow-up is dictated by the tumor pathology (benign versus malignant), extent of resection, and postoperative neurological status.
  • Benign tumors: Benign tumors require close imaging follow-up initially after surgical resection.  Eventually, if MRI scans show that the tumor is stable, imaging can be obtained annually in the absence of new symptoms.
  • Malignant tumors: Malignant tumors should be followed more closely in a multidisciplinary fashion with early involvement by neuro-oncology. These patients will be seen frequently by oncologists as adjuvant therapy is administered.

Your donations keep us going

The ISPN Guide is free to use, but we rely on donations to fund our ongoing work and to maintain more than a thousand pages of information created to disseminate the most up-to-date knowledge in the field of paediatric neurosurgery.

By making a donation to The ISPN Guide you are also indirectly helping the many thousands of children around the world whose treatment depends on well-informed surgeons.

Please consider making a donation today.

Use the app

The ISPN Guide can be used as a standalone app, both on mobile devices and desktop computers. It’s quick and easy to use.

Fully featured

Free registration grants you full access to The Guide and host of featured designed to help further your own education.

Stay updated

The ISPN Guide continues to expand both in breadth and depth. Join our mailing list to stay up-to-date with our progress.