Normal Pressure Hydrocephalus Associated with Spinal Cord Tumor

Abstract

ABSTRAa -While the association of spinal cord tumor and high-pressure hydrocephalus is well known, only 5 cases of spinal cord tumor associated with normotensive hydrocephalus have been reported. Two further cases are described here, discussing the possible pathophysiological mechanism. It is suggested that these patients go through a subclinical stage of high-pressure hydrocephalus and become normotensive later on, a process which might influence the surgical results.

Intracranial Hypertension and the Importance of Cerebral Venous Drainage Variability: A Case Report of Headache as the Initial Clinical Presentation of an Intraspinal Paraganglioma

“…9 If the increased ICP persists subclinically over a longer period, it may result in a chronic hydrocephalus with enlarged ventricles. 30 In our reported case, we found a complete obliteration of the spinal cavity by the tumoral mass coherent with the filum terminale in level L5. In our case, dilated and serpentine vessels above the tumor were notable up to the thoracic spinal cavity in MR imaging (►Fig.…”

“…A common mechanism for the association between intraspinal tumors and IH or hydrocephalus is difficult to identify, since published cases are of different tumor entities and various intraspinal localizations. 1,5,7,9, 11,16,[18][19][20][21][22][23][28][29][30] For tumors located close to the foramen magnum, blocking of the ventricular outflow of CSF into the spinal subarachnoid space towards the absorptive areas as a direct causal relationship is most apparent. 22 Explanations will be more difficult for tumors located caudally in the thoracic and lumbar spine, where the tumor entity seems to play a decisive role.…”

“…Due to small case numbers and a large variability of tumor locations and entities, a systematic investigation is still missing. 1,5,7,9,11,16,[18][19][20][21][22][23][28][29][30] We present a single case with headache and papilledema as the exclusive symptoms of an intraspinal paraganglioma coherent with the filum terminale. This report is meant to supplement the ongoing discussion about a common pathophysiology of intraspinal tumors associated with IH or hydrocephalus with special attention to (i) intraspinal cerebral venous drainage, and (ii) spinal subarachnoid space obstruction with a reduced compliance of the intraspinal CSF compartment.…”