Brainstem tumors in children: a review

Matheus Fernando Manzolli Ballestero ,Ricardo Santos De Oliveira,Luciano Furlanetti

doi:10.46900/apn.v3i1(january-april).77

Abstract

The brainstem is defined as the portion of the neural axis between the diencephalon and the cervical spinal cord. Brainstem gliomas (BSGs) can occur anywhere within this region and account for 10% to 15% of primary pediatric intracranial tumors. The development of neuroimaging allied to the refinement of surgical tools, such as improved magnification and visualization of the surgical field with more powerful surgical microscopes and sources of light, followed by the introduction of ultrasonic aspirator, anesthetic and intraoperative neurophysiological monitoring provided the neurosurgeon with conditions for a much safer surgical management of these tumors. This article reviews the current state of knowledge with regard to tumors arising in the brain stem in children, the therapeutic options available and provides recommendations with regard to management. 

Highlights

The brainstem is defined as the portion of the neural axis between the diencephalon and the cervical spinal cord
Experience over the last several decades has demonstrated that brainstem gliomas comprise a heterogeneous group of tumors, some of which with favorable long-term survival
This paper aims to review brains steam tumors in children, from clinical presentation, imaging and treatment

Summary

Introduction

The brainstem is defined as the portion of the neural axis between the diencephalon and the cervical spinal cord. Until about two decades ago, tumors within the brainstem were considered inoperable due to the high morbidity and mortality associated with surgery in this anatomical location. Experience over the last several decades has demonstrated that brainstem gliomas comprise a heterogeneous group of tumors, some of which with favorable long-term survival. The brainstem is a highly complex structure, acting as a station where fibers from the cerebral cortex transit up- and downstream the neural axis. The fact that nuclei of the cranial nerves, neural networks and other vital structures lay compactedly arranged in such a tiny space represents a great challenge for the neurosurgeon to approach intrinsic brainstem lesions [1,2,3] (Figure 1)

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