Primary brain stem tumours.

The material consisted of 31 patients with primary brain stem tumours who were investigated retrospectively. Twenty patients were younger than 16 years of age (range: 1 1/2-65 years). The mean age was 11 years. The female/male sex ratio was 19/12. Histological diagnoses were available for 18 patients. All of the verified tumours were gliomas. The diagnoses in 12 cases were made by section or biopsy; in 15 by standard clinical and radiological examinations and in 4 by exploratory operations. Headaches, mental changes, speech and gait disturbances were the most common symptoms at the onset of the illness and at the time of diagnosis. The mean latency period between the emergence of symptom(s) until diagnosis was 4 months (range: 1/2-48 months). Amongst the dominant objective findings were failure of the V, VI and VII cranial nerves, pyramidal tract symptoms, ataxia and nystagmus, occurring singly or in combination. Pneumoencephalograms disclosed characteristic changes in 25 patients (83%). Fourteen patients (45%) received radiation treatment, from which 5 (36%) obtained a temporary remission in their symptoms. The postdiagnostic mean survival period for the patients was 15 months (range: 0-92 months). The survival time was found to depend on the number of damaged cranial nerve nuclei at the time of diagnosis and on the degree of severity and duration of the accompanying hydrocephalus. The prognosis was unfavourable, as the percentage of patients who survived for 2 years was only 6%, and a total duration of illness longer than 2 years occurred in only 7 patients. None of the patients were still surviving at the conclusion of this investigation.