title: Pediatric tectal plate gliomas: clinical and radiological progression, MR imaging characteristics, and management of hydrocephalus.
abstract: OBJECTIVE
  Tectal plate gliomas are generally low-grade astrocytomas with favorable prognosis, and observation of the lesion and management of hydrocephalus remain the mainstay of treatment.
  
  
  METHODS
  A cohort of patients with tectal plate gliomas at 2 academic institutions was retrospectively reviewed.
  
  
  RESULTS
  Forty-four patients with a mean age of 10.2 years who harbored tectal plate gliomas were included in the study. The mean clinical and radiological follow-up was 7.6 ± 3.3 years (median 7.9 years, range 1.5-14.7 years) and 6.5 ± 3.1 years (median 6.5 years, range 1.1-14.7 years), respectively. The most frequent intervention was CSF diversion (81.8% of patients) followed by biopsy (11.4%), radiotherapy (4.5%), chemotherapy (4.5%), and resection (2.3%). On MR imaging tectal plate gliomas most commonly showed T1-weighted isointensity (71.4%), T2-weighted hyperintensity (88.1%), and rarely enhanced (19%). The initial mean volume was 1.6 ± 2.2 cm(3) and it increased to 2.0 ± 4.4 cm(3) (p = 0.628) at the last follow-up. Frontal and occipital horn ratio (FOHR) and third ventricular width statistically decreased over time (p < 0.001 and p < 0.05, respectively).
  
  
  CONCLUSIONS
  The authors' results support existing evidence that tectal plate gliomas frequently follow a benign clinical and radiographic course and rarely require any intervention beyond management of associated hydrocephalus.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Alabama, Birmingham;
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Griessenauer
authors.forename: Elias
authors.initials: E
authors.lastname: Rizk
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Miller
authors.forename: Philipp
authors.initials: P
authors.lastname: Hendrix
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Mark S
authors.initials: MS
authors.lastname: Dias
authors.forename: Kelsie
authors.initials: K
authors.lastname: Riemenschneider
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Chern
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D020295:Brain Stem Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D003336:Tectum Mesencephali / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult