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In 24 CT studies in children with brain stem gliomas, the CT appearance was seen to vary with the tumor's physical characteristics. Infiltrative tumors produce diffuse enlargement of the brain stem; they are isodense with brain parenchyma or of decreased density and may show partial enhancement. Some gliomas grow focally as an expansile mass or as a large exophytic lesion. These have heterogeneous density and show prominent enhancement. Early diagnosis depends on appreciation of displacement of the fourth ventricle and compression and distortion of the cisterns. The use of diagnostic studies and surgical and therapeutic results in the 24 cases are compared to 45 such cases diagnosed prior to the use of CT.
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