Rarely malignant, but often associated with intramedullary cysts containing high fluid content. CSF has a high protein concentration. Papilledema has been associated with these tumors. Occurs with equal incidence with the ependymoma. May or may not have a plane around it to ease dissection.
Malignant tumors do uniformly badly.
References Cohen AR, et al. Malignant astrocytomas of the spinal cord. Epstein F, Epstein N. Surgical management of holocord intramedullary spinal cord astrocytomas in children. Guidetti B, Mercuri S, Vagnozzi R. Longterm results of the surgical treatment of 129 intramedullary tumors. Kopelson G, Linggood RM, Intramedullary spinal cord astrocytoma versus glioblastoma.