Brainstem Glioma

Brainstem gliomas are glial neoplasms arising within the midbrain, pons, or medulla, most commonly in pediatric populations. Pathophysiology includes diffuse infiltration of glial cells leading to progressive neurological deficits. Clinical features depend on tumor location but often include cranial nerve palsies, long-tract signs, ataxia, and respiratory compromise. Diagnosis is primarily via MRI, with biopsy reserved for atypical or non-diffuse lesions. Management is challenging, typically combining radiotherapy with supportive care; prognosis is poor for diffuse intrinsic pontine gliomas, though focal lesions may have better outcomes.