Infantile Spinal Cord Tumor Presenting as Hydrocephalus

Abstract

Infantile Spinal Cord Tumor Presenting as Hydrocephalus. 2000; 20(3-4): [244][245] Although relatively rare, the association of spinal cord tumors with hydrocephalus and increased intracranial pressure, normal pressure hydrocephalus and benign intracranial hypertension is a well-recognized phenomenon.1 Usually, the hydrocephalus becomes apparent or is discovered after the diagnosis of an intraspinal tumor.1,2 In rarer circumstances, hydrocephalus is the presenting feature and evidence of spinal cord dysfunction appears subsequently. [3][4][5][6] In this report, we present the case of an infant who was treated for communicating hydrocephalus of undetermined etiology. Eleven months later, a malignant astrocytoma of the cervical spinal cord was diagnosed. Case ReportA one-year-old male infant presented with drowsiness and a progressive strabismus of one month's duration. Upon examination, severe bilateral papilledema and bilateral 6th nerve palsies were noted. The child was unable to walk without help, although he had been able to do so one month earlier. Motor power and deep tendon reflexes were normal. CT scan of the brain showed hydrocephalus involving the whole ventricular system. The region of the foramen magnum and the craniovertebral junction were normal. Thus, since there was no evidence of obstruction within the intracranial cerebral spinal fluid (CSF) pathways, a diagnosis of idiopathic communicating hydrocephalus was made.A ventriculoperitoneal shunt was inserted, after which the patient's clinical condition rapidly improved. The CSF was clear and colorless, and had no abnormalities on laboratory examination. The drowsiness and strabismus were immediately relieved and the patient was discharged within several days. He remained well at follow-up, and when examined at the age of 18 months, he was walking independently without neurological abnormality. At the age of 23 months, his parents noted clumsiness of his right upper limb.

11 Years Old Female with Synergistic Presentation of Cranial and Spinal Pathologies: Myxopapillary Ependymoma with Hydrocephalus - A Rare Entity

“…It is observed that there is no obvious obstructive pathology on neuroimaging in such cases of hydrocephalus and spinal tumor. 4,5,6 CSF examination of these patients showed a high concentration of proteins which can be the cause of hydrocephalus. [7][8] The presentation of hydrocephalus in these patients is usually covert.…”