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What’s a brainstem glioma?

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Brain stem gliomas are fast-growing tumors that occur in the brain stem, most commonly in children and adolescents. They are difficult to treat and the prognosis varies depending on the location of the tumor. Radiation therapy is the preferred method of treatment, but patients with pontine gliomas have a low chance of survival.

A brain stem glioma is a tumor that occurs in the brain stem. It is most common in children and adolescents under the age of 20, but also occurs in adults between the ages of 30 and 40. These tumors are fast growing, highly aggressive, and difficult to treat. The prognosis varies depending on the location of the tumor.
These tumors can occur in three parts of the brain. Some brainstem glioma tumors occur on the midbrain, which is deep in the center of the brain. Others occur on the pons, which is the section just below the midbrain. The medulla oblongata, which lies between the pons and spinal cord, is also susceptible to gliomas.

Most brainstem tumors occur on the pons. These tumors, called pontine gliomas, affect the nerves and muscles around the face. This causes problems such as double vision and can make it difficult for the patient to chew or swallow food. As the tumor grows, the patient may also have trouble walking or feel weakness in their limbs.

Depending on the location of the brainstem glioma, patients might also experience hydrocephalus, which is a condition in which cerebrospinal fluid builds up in the brain. People who have this condition might experience frequent headaches, difficulty walking or maintaining balance, and stomach pain. Patients may also complain that they cannot feel one side of their face, or half of their face may seem droopy.

Doctors diagnose brainstem glioma tumors by doing magnetic resonance imaging (MRI) tests. These noninvasive tests allow them to look inside the brain for the presence of tumors. They might also use computed tomography (CT) scans, although these tests are often not as accurate as MRIs.

Patients who have brainstem gliomas have limited options when it comes to treatment. The tumors are located in a sensitive part of the brain and tend to spread rapidly throughout the area, so doctors are often unable to perform surgery. Radiation therapy is also a risky option, because high doses can cause permanent damage to the brainstem.

Despite the risks, radiation therapy is the preferred method of treatment, because brainstem glioma tumors generally respond more favorably to radiation therapy than to chemotherapy. Some doctors also prescribe medications to control secondary symptoms. Corticosteroids reduce inflammation and other medications, such as dexamethasone, can control swelling.
Patients who have pontine gliomas, or tumors on the bridge, usually don’t live more than a year after diagnosis. The chances of surviving a medullary or midbrain glioma are considerably higher. Patients have about a 65-90% chance of long-term survival when treated with radiation therapy.

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