Glioma is the general name for any tumor that arises from the supportive tissue of the brain and spinal cord. This supportive tissue helps keep the neurons (“thinking cells”) in place and functioning well.
Brain Stem Gliomas usually arise in the “stem of the brain” (located at the bottom of the brain), which contains all the connections carrying messages from the brain to the spinal cord. The brain stem also contains important structures involved in eye movements and muscle control and sensation of the face and throat. It may be difficult to determine the grade of the tumor due to the high risk of performing any surgical procedure in this area of the brain. However, the diagnosis can usually be based on what the doctor sees on the MRI. Most of these tumors are classified by their location.
Symptoms depend on the location of the tumor. The most common are eye movement abnormalities that cause double vision. Other symptoms include weakness or sensation changes in the face, swallowing difficulties and hoarseness. Weakness, loss/changes in sensation or poor coordination on one side of the body may occur. The tumor may block the flow of cerebral spinal fluid causing headaches, nausea, vomiting, and unsteady gait.
Treatment of brain stem gliomas is based on the tumor location, the grade and the symptoms.
Most of these tumors are not able to be surgically removed. Surgery may be helpful if a tumor appears contained or on the outside of the brain. The goals of surgery are to determine the grade and type of tumor and, sometimes, to remove the tumor. A shunt may be placed if there is a blockage of cerebral spinal fluid circulation. Radiation therapy may be used early if there are significant symptoms, or it may be postponed until the tumor grows or causes symptoms.
Radiosurgery can be considered if the tumor appears localized.