title: Magnetic resonance imaging differential diagnosis of brainstem lesions in children.
abstract: Differential diagnosis of brainstem lesions, either isolated or in association with cerebellar and supra-tentorial lesions, can be challenging. Knowledge of the structural organization is crucial for the differential diagnosis and establishment of prognosis of pathologies with involvement of the brainstem. Familiarity with the location of the lesions in the brainstem is essential, especially in the pediatric population. Magnetic resonance imaging (MRI) is the most sensitive and specific imaging technique for diagnosing disorders of the posterior fossa and, particularly, the brainstem. High magnetic static field MRI allows detailed visualization of the morphology, signal intensity and metabolic content of the brainstem nuclei, together with visualization of the normal development and myelination. In this pictorial essay we review the brainstem pathology in pediatric patients and consider the MR imaging patterns that may help the radiologist to differentiate among vascular, toxico-metabolic, infective-inflammatory, degenerative and neoplastic processes. Helpful MR tips can guide the differential diagnosis: These include the location and morphology of lesions, the brainstem vascularization territories, gray and white matter distribution and tissue selective vulnerability.
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Carlo Cosimo
authors.initials: CC
authors.lastname: Quattrocchi
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Errante
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Maria Camilla
authors.initials: MC
authors.lastname: Rossi Espagnet
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Galassi
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Sabino Walter
authors.initials: SW
authors.lastname: Della Sala
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bernardi
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fariello
authors.affiliation: Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Longo
keywords: Brainstem; Differential diagnosis; Magnetic resonance; Neuroradiology; Pediatrics
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