Intraspinal tumour presenting as hydrocephalus in childhood

Prasad, V. S. S. V.; Basha, A.; Prasad, B. C. M.; Reddy, D. Raja

doi:10.1007/bf00301081

Cited by 19 publications

(6 citation statements)

References 10 publications

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“…One of these two patients further developed hydrocephalus with an unclear mechanism of evolution. Such an association is rare and reviewed by Prasad et al [31] for a series of benign lesions, and while cranial extension of the tumor may be the most likely explanation for our patient, other theories include increased protein content and viscosity of CSF, occluded arachnoid granulations, tumor-induced meningeal inflammatory reaction, and spinal subarachnoid obstruction.…”

Section: Discussionmentioning

confidence: 99%

Congenital Tumors of the Central Nervous System: The MCH Experience

et al. 2009

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Introduction: Congenital brain tumors in the younger pediatric population are rare lesions that are histologically distinct from those in the older pediatric population. Malignant histology is common, with persistently poor outcomes despite accessible neuroimaging and evolving adjuvant therapy. There remains scant literature about the natural history of these patients because of rarity and varied institutional experiences. Methods: A retrospective review was performed of congenital brain tumor patients surgically treated at the Montreal Children’s Hospital (MCH) over a 22-year period. Patients presenting in the first year of life were evaluated for demographic information, presenting symptoms, lesion location, and management. Analysis was by median rank test and χ² statistics. Results: 13 cases of congenital brain tumors were identified: 5 supratentorial and 8 infratentorial. Median age (p = 0.93) and gender (p = 0.57) did not differ by location, and predominant histologies were choroid plexus papilloma and primitive neuroectodermal tumor. Seizure activity was exclusive to supratentorial lesions (40%, p = 0.03), with hypotonia observed only among infratentorial lesions (50%, p = 0.02). There was equal incidence of hydrocephalus (69%, p = 0.57) and increasing head circumference (38%, p = 0.27) by lesion location. Supratentorial lesions were treated by total resection (n = 3), subtotal resection (n = 1), and biopsy (n = 1). Infratentorial lesions were treated by total resection (n = 1), subtotal resection (n = 2), biopsy (n = 1), no operation (n = 2), and decompressive laminectomy for two spinal lesions. Conclusions: Congenital brain tumor patients represent fewer than 2% of patients treated at MCH. An evolving understanding of management objectives for these lesions requires understanding institutional experiences. Patients with supratentorial lesions frequently present with seizures, hydrocephalus, and macrocrania, and more frequently underwent total resection at surgery.

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Section: Discussionmentioning

confidence: 99%

Congenital Tumors of the Central Nervous System: The MCH Experience

et al. 2009

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“…[7–9] In high-grade tumors, the subarachnoid spread of tumor creates an increase in outflow resistance at the level of the basal cisterns, explaining the genesis of the hydrocephalus. In low-grade tumors, the causative mechanism of hydrocephalus is much more controversial,[8] where an anatomical isolation of the spinal subarachnoid space from the intracranial compartment caused by the presence of the tumor has been held responsible for the hydrocephalus.…”

Section: Clinical Presentationmentioning

confidence: 99%

Intramedullary tumors in children

Chatterjee¹,

Chatterjee²

2011

J Pediatr Neurosci

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Intramedullary tumors of the spinal cord account for 35-40% of intraspinal tumors in children. The biological behavior of these tumors is of slow progression, and hence aggressive surgery has been advocated. Surgical adjuncts include use of intraoperative neurophysiological monitoring, preoperative ultrasound, microsurgical techniques and ultrasonic suction devices. Osteoplastic laminoplasty approaches avoid post-laminectomy deformities in younger children. Postoperative radiotherapy and more recently chemotherapy regimes have been proposed for incompletely resected tumors.

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“…Pain is the most common presenting symptom in patients with intramedullary tumors; with weakness, gait deterioration, torticollis also being frequently reported [8,10]. The cervical spine is the region of the spine most affected [1,2,3,5]. The apparent early absence of spinal cord symptoms in children harboring intramedullary tumors is explained by lack of specificity of clinical and neurological findings [4,10].…”

Section: Neurological Findingsmentioning

confidence: 99%

“…The efficacy of endoscopy to treat cases with secondary hydrocephalus due to neoplastic dissemination of central nervous system tumors is not clearly evident in the literature [19,22]. Routine placement of a VP shunt is the standard practice in these cases [3,13]. While in patients with tumoral CSF dissemination at the initial presentation, third ventriculostomy, by controlling hydrocephalus, permits chemotherapy to be undertaken prior to tumor resection [19].…”

Section: Third Ventriculostomy and Communicating Hydrocephalusmentioning

confidence: 99%