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Posterior Mesencephalic and Pontine Pilocytic Astrocytoma

Last Updated: September 28, 2018

Resection of a Posterior Mesencephalic and Pontine Pilocytic Astrocytoma

This chapter describes the techniques for resection of dorsal brainstem gliomas along the superior pons and mesencephalon.  For general considerations, diagnosis, evaluation, and preoperative/postoperative considerations, please refer to the chapter on the Principles of Brainstem Surgery.

Removal of gliomas located within the brainstem is risky and not commonly advised. Very focal benign gliomas, such as pilocytic astrocytomas, are an exception; the offer of surgery should be judiciously considered.  Most such tumors are not operative candidates unless the tumor is cystic and the nodule is in the proximity of a safe pial surface.

Figure 1: Focal cystic brainstem pilocytic astrocytoma of the pons and midbrain is...