Brainstem tumors in children: a review

The brainstem is defined as the portion of the neural axis between the diencephalon and the cervical spinal cord. Brainstem gliomas (BSGs) can occur anywhere within this region and account for 10% to 15% of primary pediatric intracranial tumors. The development of neuroimaging allied to the refinement of surgical tools, such as improved magnification and visualization of the surgical field with more powerful surgical microscopes and sources of light, followed by the introduction of ultrasonic aspirator, anesthetic and intraoperative neurophysiological monitoring provided the neurosurgeon with conditions for a much safer surgical management of these tumors. This article reviews the current state of knowledge with regard to tumors arising in the brain stem in children, the therapeutic options available and provides recommendations with regard to management