Long-Standing Overt Ventriculomegaly in Adults: A Systematic Review and Meta-Analysis of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunt as First-Line Treatment

Gillespie, Conor S; Fang, Wen Yung Stephanie; Lee, Keng Siang; Clynch, Abigail L; Alam, Ali M; McMahon, Catherine

doi:10.1016/j.wneu.2023.03.064

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…LOVA describes a heterogeneous adult hydrocephalus, which usually has a slow progression. [ 3 ] To the best of our knowledge, there are no reports of pituitary apoplexy causing subacute symptomatic hydrocephalus in LOVA patients or reports of pituitary apoplexy causing “nonobstructive” sNPH. Nevertheless, a recent study described a rare case of cerebral vasospasm, which is a well-known complication of aneurysmal SAH, caused by pituitary apoplexy.…”

Section: Discussionmentioning

confidence: 99%

Secondary normal pressure hydrocephalus following pituitary apoplexy: A case report

Tomita,

Fukuda,

Kobashi

et al. 2024

Surgical Neurology International

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Background: Although secondary normal pressure hydrocephalus (sNPH) can occur in various central nervous system diseases, there are no reports of sNPH caused by pituitary lesions. Herein, we present a unique case of sNPH caused by pituitary apoplexy. Case Description: A 70-year-old man was transferred to our hospital because of a sudden onset of headache and loss of consciousness. The cerebrospinal fluid (CSF) test showed slightly elevated cell counts and protein levels but a negative CSF culture test. Magnetic resonance imaging showed a dumbbell-like cystic lesion with hemorrhagic change at the sella turcica. From the above, the patient was diagnosed with aseptic meningitis caused by pituitary apoplexy. Pituitary hormone replacement therapy was undertaken, and his symptoms fully improved. However, two months later, he complained of a gait disturbance and incontinence that had gradually appeared. Brain imaging with computed tomography showed no ventricular enlargement compared with initial images, although the lateral ventricles were slightly enlarged. As a CSF drainage test improved his symptoms temporarily, sNPH with possible longstanding overt ventriculomegaly in adults (LOVA) background was suspected. We performed a lumboperitoneal shunt (LPS) placement, which improved his symptoms. Conclusion: This case suggests that sNPH can develop even after a small subarachnoid hemorrhage caused by a pituitary apoplexy in LOVA patients. If the aqueduct of Sylvius is open, sNPH with a LOVA background can be successfully treated with LPS placement.

show abstract

Section: Discussionmentioning

confidence: 99%

Secondary normal pressure hydrocephalus following pituitary apoplexy: A case report

Tomita,

Fukuda,

Kobashi

et al. 2024

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

Secondary normal pressure hydrocephalus following pituitary apoplexy: a case report.

Tomita,

Fukuda,

Kobasi

et al. 2024

Preprint

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Introduction: Although secondary normal pressure hydrocephalus (sNPH) can occur in various central nervous system diseases, there are no reports of sNPH caused by pituitary lesions. Herein, we present a unique case of sNPH caused by pituitary apoplexy. Case Presentation: A 70-year-old man was transferred to our hospital because of sudden onset of headache and loss of consciousness. Cerebrospinal fluid (CSF) test showed slightly elevated cell counts and protein levels, but a negative CSF culture test. Magnetic resonance imaging showed a dumbbell-like cystic lesion with hemorrhagic changeat the sella turcica. From the above, the patient was diagnosed with aseptic meningitis caused by pituitary apoplexy. Pituitary hormone replacement therapy was undertaken and his symptoms fully improved. However, 2 months later he complained of a gait disturbance and incontinence that had gradually appeared. Brain imaging with computed tomography showed no ventricular enlargement compared with initial images, although the lateral ventricles were slightly enlarged. As a CSF drainage test improved his symptoms temporarily, sNPH with possible longstanding overt ventriculomegaly in adults (LOVA) background was suspected. We performed a lumbo-peritoneal shunt placement, which improved his symptoms. Conclusions: This case suggestes that sNPH can develop even after a small subarachnoid hemorrhage caused by a pituitary apoplexy in LOVA patients. If the aqueduct of Silvius is open, sNPH with a LOVA background can be successfully treated with lumbo-peritoneal shunt placement.

show abstract

Long-Standing Overt Ventriculomegaly in Adults: A Systematic Review and Meta-Analysis of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunt as First-Line Treatment

Cited by 2 publications

References 27 publications

Secondary normal pressure hydrocephalus following pituitary apoplexy: A case report

Secondary normal pressure hydrocephalus following pituitary apoplexy: A case report

Secondary normal pressure hydrocephalus following pituitary apoplexy: a case report.

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