Tectal plate gliomas: a review

Introduction Tectal plate gliomas are generally benign neoplastic lesions arising in the brainstem which can, with local extension, obstruct the aqueduct of Sylvius and lead to hydrocephalus. Anatomy Diagnosis is based on initial suspicion fostered by the presentation of an obstructive hydrocephalus...

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Bibliographic Details
Published in:Child's nervous system 2013-10, Vol.29 (10), p.1827-1833
Main Authors: Igboechi, Chiazor, Vaddiparti, Aparna, Sorenson, Edward P., Rozzelle, Curtis J., Tubbs, R. Shane, Loukas, Marios
Format: Article
Language:English
Subjects:
Benign
Brain Stem Neoplasms - complications
Brain Stem Neoplasms - pathology
Glioma - complications
Glioma - pathology
Humans
Hydrocephalus - etiology
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Review Paper
Tectum Mesencephali - pathology
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Summary:Introduction Tectal plate gliomas are generally benign neoplastic lesions arising in the brainstem which can, with local extension, obstruct the aqueduct of Sylvius and lead to hydrocephalus. Anatomy Diagnosis is based on initial suspicion fostered by the presentation of an obstructive hydrocephalus followed by physical exam which may potentially reveal indications of pyramidal tract dysfunction or cranial nerve palsies. Discussion MRI studies reveal a characteristic well-circumscribed, isodense or hypodense mass on T1-weighted images, with hyperdensity on T2 imaging. Yet current radiological methods insufficiently distinguish tectal plate gliomas from brainstem tumors or gliomas in the neighboring structures, and a definitive diagnosis requires biopsy and histopathological analysis. Management is planned according to the degree of associated signs and symptoms, and may range from diligent observation and periodic screening for advancing tumor development, to cerebrospinal fluid shunting in an effort to resolve obstructive hydrocephalus, to radio- and chemotherapy. A wide range of minimally invasive approaches using endoscopy is available for the neurosurgeon, including endoscopic third ventriculostomy and endoscopic aqueductoplasty.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-013-2110-z