Increased intracranial pressure associated with Spinal Cord Tumours

Abstract

Two cases of spinal cord tumour associated with increased intracranial pressure are reported and the 44 cases described in the literature are reviewed. The different hypotheses produced to explain the pathogenic mechanism of this syndrome are discussed. We think that several factors working together, rather than an isolated mechanism, take part in the production of this syndrome.

Normal Pressure Hydrocephalus Associated with Spinal Cord Tumor

“…More than 50 cases of spinal cord tumor associated with high-pressure hydrocephalus have been described (1)(2)(3)(4)(5). Pathophysiological explanations are based mainly on two assumptions: i) changes in CSF composition, related to tumor secretions, and ii) changes in CSF dynamics, related mainly to tumor location.…”

“…Possible reasons for high protein concentrations above the tumor are transudation from the tumor, active secretion (mainly from neurinomas), tumoral bleeding (mainly from ependymomas), and rupture of tumor cells into the CSF (1-3,6). Other theories advanced to explain CSF malabsorption in the presence of spinal tumor are arachnoiditis caused by certain tumoral protein fractions (2), recurrent tumoral bleeding causing meningeal adhesions (1,21), seeding of tumor cells (22) and high fibrinogen level in the CSF (7). Currently, none of the above theories, perse, could supply a satisfactory explanation of the signs and symptoms of all cases reported.…”

“…The association of spinal cord tumor and high-pressure hydrocephalus is well known and has been described in more than 50 cases (1)(2)(3)(4)(5). The mechanism is thought to be a high protein content of the cerebrospinal fluid (CSF) that interferes with spinal fluid absorption at the arachnoid villi (1)(2)(3)6). Most of these patients have had high-pressure hydrocephalus with papilledema.…”

The spinal tumour related hydrocephalus

“…Spinal tumours most commonly associated with hydrocephalus are spinal ependymomas or ependymoblastomas [4,17,20,21,23]. These tumours are known to be particularly prone to subarachnoid spread.…”