Brain-stem glioma growth patterns

Fred J. Epstein M.D. 1 and Jean-Pierre Farmer M.D., CM., F.R.C.S.(C) 1
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  • 1 Division of Pediatric Neurosurgery, New York University Medical Center, New York, New York, and Department of Neurosurgery, The Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
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✓ During the last decade, several authors have reported that certain brain-stem gliomas may be associated with a better prognosis than others. In this paper, retrospective correlations between the pathological findings and the magnetic resonance (MR) imaging appearance of 88 brain-stem gliomas are established. The authors propose an anatomical hypothesis that helps identify glioma growth patterns in general and that clarifies why cervicomedullary, dorsally exophytic, and focal tumors have a more favorable prognosis. According to this hypothesis, growth of benign gliomas of the brain stem is guided by secondary structures such as the pia, fiber tracts, and the ependyma, which in turn leads to stereotypical growth patterns that are clearly identified on MR images. The authors believe that this hypothesis, in conjunction with clinical data, may help establish selection criteria for the surgical treatment of specific brain-stem lesions.

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Contributor Notes

Address reprint requests to: Jean-Pierre Farmer, M.D., The Montreal Children's Hospital, 2300 Tupper, Room C-811, Montreal, Quebec H3H 1P3, Canada.
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