Intracranial hypotension in patient with chiasmatic / hypothalamic glioma

Case contributed by Dr Ammar Haouimi

Presentation

Had surgery with VP shunting for brain tumour 3 months ago, presented with headaches.

Patient Data

Age: 6 years
Gender: Male

The MRI sequences show a lobulated mass centered on the suprasellar region with extension to the anterior portion of the 3rd ventricle and interpeduncular cistern. It appears of low signal on T1, inhomogeneous high signal FLAIR and T2 with heterogeneous enhancement on postcontrast sequences. The optic chiasma is not visualized as a separate structure.

The intraventricular drain is seen in the right occipital horn with normal size and configuration of the lateral ventricles.

Diffuse and extensive pachymeningeal thickening and enhancement over both cerebral hemispheres as well as the cerebral posterior fossa, suggesting intracranial hypotension. 

Case Discussion

This patient had surgery (open biopsy) through a frontal craniotomy for chiasmatic / Hypothalamic glioma with ventriculoperitoneal shunting for his obstructive hydrocephalus at the same time. Now he developed an intracranial hypotension most likely due to an over drainage of the VP shunt.

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Case information

rID: 60544
Published: 29th May 2018
Last edited: 31st May 2018
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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