Bilateral thalamic gliomas are rare but characteristic low-grade astrocytomas that occur in both children and young adults.
Presentation may vary with age. Young children with bilateral thalamic glioma often have signs of increased intracranial pressure and movement disorders, while older children and adults often experience mental deterioration with behavioral impairment such as personality changes or dementia.
It is a type of low-grade astrocytoma (World Health Organization grade II).
CT and MRI typically show expansion of both thalami. While often symmetric, the involvement can also be asymmetric. Tumors may spread to involve the striatum. Depending on the degree of mass-effect, there may be accompanying hydrocephalus.
- T2/FLAIR: hyperintense
- T1: isointense
- DWI: no diffusion restriction
- T1 C+ (Gd): no post-contrast enhancement
Treatment and prognosis
Because of the deep location of the lesions, prognosis is very poor despite therapy.
- 1. Estève F, Grand S, Rubin C, Hoffmann D, Pasquier B, Graveron-Demilly D, Mahdjoub R, Le Bas JF. MR spectroscopy of bilateral thalamic gliomas. (1999) AJNR. American journal of neuroradiology. 20 (5): 876-81. Pubmed
- 2. Smith AB, Smirniotopoulos JG, Rushing EJ, Goldstein SJ. Bilateral thalamic lesions. (2009) AJR. American journal of roentgenology. 192 (2): W53-62. doi:10.2214/AJR.08.1585 - Pubmed
- 3. Partlow GD, del Carpio-O'Donovan R, Melanson D, Peters TM. Bilateral thalamic glioma: review of eight cases with personality change and mental deterioration. (1992) AJNR. American journal of neuroradiology. 13 (4): 1225-30. Pubmed
- 4. Hegde AN, Mohan S, Lath N, Lim CC. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. (2011) Radiographics : a review publication of the Radiological Society of North America, Inc. 31 (1): 5-30. doi:10.1148/rg.311105041 - Pubmed