Diffuse midline glioma presenting with central sleep apnea and pulmonary hypertension in a four-year-old patient: a case report.

None Central sleep apnea is a rare disorder in pediatric population with various initial presentations and is secondary to many underlining diseases. This is a four-year-old boy with episodes of syncope. He also had pulmonary hypertension and cardiomegaly. Polysomnography showed the finding for central sleep apnea with the apnea-hypopnea index (AHI) being high (up to 138.1/hour). Brain magnetic resonance imaging (MRI) showed an ill-defined area near the medulla oblongata and lower pons. The lesion from a brainstem biopsy confirmed the diagnosis of low-grade glioma. Conservative medical follow up was suggested, and the picture of the brain MRI six months later showed no obvious tumor progression. To our best knowledge, this is the first case report that work-up on the cause of syncope and pulmonary hypertension, leading to the final diagnosis of central sleep apnea and a brain neoplasm.