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ANGIOGRAPHIC FEATURES OF BRAIN STEM TUMORS AND DIFFERENTIAL DIAGNOSIS FROM FOURTH VENTRICLE TUMORS

YUN PENG HUANG M.D. and BERNARD S. WOLF M.D.

1. Tumors of the brain stem show characteristic angiographic features in both arterial and venous phases. These result from the central location of the tumor and more or less symmetric expansion displacing adjacent vessels. Specific angiographic features depend on the location and size of the tumor. Pseudo-extra-axial or paradoxical displacements of vessels are emphasized as characteristic of brain stem astrocytomas.

2. Angiographic features of extension of a brain stem tumor into the cerebellar hemisphere, mesencephalon, floor of the third ventricle, tectum, medulla oblongata and upper cervical cord are described.

3. While both brain stem tumor and fourth ventricle tumors share several angiographic features, there are sufficient differential criteria to permit correct diagnosis in the majority of cases. Differentiation is based on the recognition of vessels which serve as landmarks for the fourth ventricle and the cerebellar tonsils.


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