Brainstem Glioma, Low Grade

4-year-old female with a history of altered sensorium and seizures. There is an infiltrative T1-hypointense, T2/FLAIR hyperintense mass within the pons and medulla. The lesion is T2/FLAIR hyperintense, does not enhance, and does not restrict diffusion. Differential diagnosis includes brainstem glioma, pilocytic astrocytoma, ependymoma and medulloblastoma. Findings are most compatible with a diffuse brainstem glioma. Brainstem gliomas account for about 25% of all posterior fossa tumors. Common clinical presentations include ataxia, cranial nerve palsies, long tract signs and hydrocephalus. Lesions can be associated with neurofibromatosis-1. Treatment and prognosis depends on tumor type and location. NMR 321

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