Neurology & Neuroscience

Introduction: Primary brain tumors, including brainstem gliomas, are a diverse group of diseases that together constitute the most common solid tumor of childhood. Immunohistochemical analysis, cytogenetic and molecular genetics findings, and measures of mitotic activity are increasingly used in tumor diagnosis and classification. Most children with DIPG are diagnosed between the ages of 5 and 10 years. Focal pilocytic astrocytomas in the brain stem occur less frequently. The goals of our study is to highlight through a literature review since the 1975s to nowadays the progress in the management of DIPG in children and to reach a consensus in our contexts in Africa and to share our experience with multimodal management results about 12 cases in our neurosurgery department.

Materials –Methods: This is a retrospective monocentric study (Department of Neurosurgery Specialty Hospital of Rabat). Included are all children with DIPG Brainstem who managed between January 2008 to December 2018. We studied sex, age, management.

Results: 12 patients were included. The Average age is 6.4Y with extremis 1.3year to 17Y. The sex ratio is two with 67% of boys and 13% of girls. We performed BST on three cases to have histology, and two patients have focal resection, 6 patients benefited shunt (VCS, DVP), and all of our patients had benefited neurooncology treatment, and we have three cases who are benefited directly chemotherapy and X-Ray Therapy before multidisciplinary staff and didn’t benefited any surgery procedure.

Conclusion: Brain tumors have classified according to histology, but tumor location and extent of spread are important factors that affect treatment and prognosis. Approximately 300 to 400 pediatric brain stem tumors are diagnosed each year in the United States. DIPG accounts for approximately 75% to 80% of pediatric brain stem  tumors and constitue 15-20% of all CNS tumours in children and the main cause of death.