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Brain Sten Glioma





The prognosis varies significantly depending on the tumor type: diffuse infiltrating vs focal


Patients with diffuse infiltrating brain stem gliomas have a very poor outcome

  • 5-20% overall survival at 2 years. 
  • Median time to progression is between 5 and 9 months
  • Median overall survival ranges from 8 to 11 months.

Intratumoral hemorrhage occurs in up to 20% of patients with diffuse brain stem gliomas and may complicate clinical management.


Patients with focal brain stem glioma have ~90% overall survival at 2 years.

  • Certain tumor locations are associated with a better prognosis.  Midbrain tumors in children have a median survival of 50 months; these are also more likely to be focal gliomas. 
  • Race and gender of patients, hydrocephalus and tumor necrosis have not been found to affect survival.    
  • Brain stem gliomas in patients with NF-1 are generally indolent and may not require treatment for years. 


Morbidity is highly dependent on the location of the lesion and its compression of the surrounding structures. As brain stem structures are responsible for the regulation of basic body functions, their damage can have a substantial neurological effects. 


Comparison of prognostic factors:

Poor Prognostic Factors

Favorable Prognostic Factors

Short clinical history with multiple brain stem signs

Longer duration of symptoms (>12 months)

Diffuse involvement of the pons

Exophytic tumor with cystic components

Focal cervicomedullary and tectal tumors

Calcification on CT scan

High-grade tumor pathology Low-grade tumor pathology
Very young age (<2 years) Neurofibromatosis type 1



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