A 40yrs of female patient admitted with the c/o high grade fever, neck stiffness, slurred speech, diplopia, confused, irrelevant talking. Did MRI(plain)brain and started on antiviral, anticonvulsant, mannitol and steroid. After a few days patient has developed paraplgia, did Spectroscopy. Report says pontine glioma. What will be the further plan,management and prognosis?



Pontine glioma consider for stereotactic biopsy. Patient to receive radical dose radiotherapy 54-60 gy depending upon the dose constraints to critical organs at risk. Prognosis is generally not good and they are not long survivors..

She might not be amenable to tumour surgery directly.....results not good Hydrocephalus if present....shunt can be done palliative RT is the only option But is palliative and imperical only Please give mri images

Will wait what neurosurgeons have to say?? But the clinical presentation what you have given is not matching with a diagnosis of pontine glioma MRS is not that specific

Stereotactic biopsy would be great to prove or disprove the disgnosis It's done in dome centres in Bombay, Bangalore and vellore If the diagnosis is confirmed then radiotherapy will be helpful

CSF examination,antibiotics,anticonvulsants,mannitol and antipyretics. Gen.supportive treatment. Once the infection is under control,repeat MRI of brain . If the lesion in pons persists,stereoscopic biopsy.If malignant glioma,radiotherapy.

History is in favour of infectious or postinfectious demyelination involving brainstem and spinal cord.. It can be encephalomyelitis.. Please post proper images with all sequences.

patient hd fever earlier..is it glioma or encephalitis.?

please send this patient to neurosurgeon for proper management.

Plz post the MRI images all sequences with contrast for opinion regarding diagnosis and approach for surgery stereotactic or microsurgical. Its very imp to see the images rather than report.

It could be still viral encephalitis, because it is involving the thalamus and pons as well... Other possibility is adem

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