MCQ FRCR -----BRAINSTEM GLIOMA

Q.All are true regarding brainstem glioma except

a. pontine glioma occurs most often between 5 and 6 years of age

b.pontine glioma  is diffusely infiltrating and tends to run a malignant course

c. In general, midbrain tumours have a tendency to be indolent and of low-grade astrocytic nature

d. Contrast enhancement of a medullary tumor does not necessarily mean an aggressive tumor

e. Hydrocephalus is relatively infrequent in midbrain tumour tumors

337.----e

Hydrocephalus is relatively infrequent in pontine tumors .In contrast to pontine and medullary tumors, hydrocephalus is the common presenting finding in patients with midbrain tumors.

On a nonenhanced CT, one third of the pontine tumors are hypodense, one third are isodense, and one fourth are mixed density, both decreased and isodense. Only 5% of tumors are of increased density, with the increased density representing either calcification or blood, and the hemorrhagic focus usually indicating a malignant zone within the tumor 

Masses that are predominately hyperdense in pons, with or without surrounding focal edema, should be considered as possible cavernomas . The mass that shows a rim of hemosiderin hypointensity on T2 or T2* should be thought of as a cavernoma of the brainstem and followed with imaging.