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Current
management of Brainstem Gliomas
George I Jallo MD, Diana Freed
MS,
Chan Roonprapunt MD,
PhD and Fred Epstein MD
Division
of Pediatric Neurosurgery, Institute for Neurology and Neurosurgery,
Beth Israel Medical Center, New York, New York
Correspondence: Jallo GI MD, gjallo1@jhmi.edu
Brainstem
gliomas have historically been one of the most difficult pediatric cancers to
treat.
Tumors arising in the brainstem were once uniformly discounted as
surgically unresectable lesions.
Early neurosurgeons thought this location to be
inoperable and fraught with disaster.
The advent of computed tomography (CT),
magnetic resonance imaging (MRI) and sophisticated neurophysiological monitoring
techniques have significantly advanced the surgical treatment of these
precarious lesions.
Brainstem gliomas are now recognized as a heterogenous group
of tumors.
They have been broadly classified into several categories depending
upon the classification scheme.
All these classification systems provide a
framework to predict growth patterns, surgical resectability and overall
prognosis for these heterogeneous tumors.
These systems allow the surgeon to
better differentiate the low-grade tumors from the diffuse inoperable tumor
type.
The authors review the current management of brainstem tumors and their
experience with brainstem gliomas in a 5 year period.
©
Annals
of Neurosurgery, 2003
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