Hydrocephalus presenting as idiopathic aqueductal stenosis with subsequent development of obstructive tumor: report of 2 cases demonstrating the importance of serial imaging

Abstract

<jats:p>The authors describe 2 cases of triventricular hydrocephalus initially presenting as aqueductal stenosis that subsequently developed tumors of the pineal and tectal region. The first case resembled late-onset idiopathic aqueductal stenosis on serial imaging. Subsequent imaging revealed a new tumor in the pineal region causing mass effect on the midbrain. The second case presented in a more typical pattern of aqueductal stenosis during infancy. On delayed follow-up imaging, an enlarging tectal mass was discovered. In both cases hydrocephalus was successfully treated by cerebrospinal fluid diversion prior to tumor presentation. The differential diagnoses, diagnostic testing, and treatment course for these unusual cases are discussed. The importance of follow-up MRI in cases of idiopathic aqueductal stenosis is emphasized by these exemplar cases.</jats:p>

Progression of Low-Grade Glioma During Pregnancy With Subsequent Regression Postpartum Without Treatment—A Case Report

“…Additionally, when the lesion first arose cannot be ascertained with certainty. There are case reports of pediatric patients diagnosed with hydrocephalus secondary to aqueductal stenosis that later were identified to develop an obstructive tumor, 13 and this scenario may be the case for the patient described in this report.…”

Abdominal pseudocyst complicating ventriculoperitoneal shunt: A rare indication for ventriculopleural shunt conversion

“…The etiology identified was aqueductal stenosis which was managed with a VP shunt. Several studies have been conducted where newborns and infants with aqueductal stenosis had undergone VP shunt placement, which is considered the mainstay of treatment for congenital hydrocephalus 19,20 . Our patient developed a CSF pseudocyst due to obstruction of the distal end of the VP shunt via a clot.…”

“…Several studies have been conducted where newborns and infants with aqueductal stenosis had undergone VP shunt placement, which is considered the mainstay of treatment for congenital hydrocephalus. 19,20 Our patient developed a CSF pseudocyst due to obstruction of the distal end of the VP shunt via a clot. The symptoms of APC include abdominal pain, distension, nausea, vomiting, decreased appetite, constipation, fever, and signs of shunt malfunction such as lethargy and headache.…”