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Cauda equina neurinoma associated with normal pressure hydrocephalus--case report
K Nishida1, S Ueda, K Matsumoto
1Department of Neurosurgery, School of Medicine, University of Tokushima.
Neurologia Medico-Chirurgica
|April 1, 1990
Summary
Spinal tumors can cause normal pressure hydrocephalus (NPH) by increasing cerebrospinal fluid protein. Surgical removal of the tumor resolved NPH symptoms and normalized fluid protein levels in this case.
Area of Science:
- Neurology
- Neurosurgery
- Oncology
Background:
- Normal pressure hydrocephalus (NPH) is a neurological condition characterized by gait disturbance, urinary incontinence, and cognitive decline.
- Spinal tumors are rare causes of NPH, with only 10 previous cases reported in the literature.
- Elevated cerebrospinal fluid (CSF) protein is a potential contributing factor to NPH development in the context of spinal pathology.
Observation:
- A 45-year-old male presented with classic NPH symptoms: gait disturbance, urinary incontinence, and memory impairment.
- Diagnostic imaging, including computed tomographic (CT) scans and myelography, revealed dilated cerebral ventricles and a spinal tumor involving the cauda equina.
- Cerebrospinal fluid analysis showed xanthochromia and elevated protein levels.
Findings:
- Surgical resection of the spinal tumor led to complete resolution of the patient's NPH symptoms.
- Post-operative normalization of CSF protein levels was observed.
- Follow-up CT scans demonstrated a reduction in cerebral ventricular size, indicating reversal of hydrocephalus.
Implications:
- This case reinforces the association between spinal tumors and normal pressure hydrocephalus.
- Elevated CSF protein secondary to spinal tumors may play a crucial role in the pathogenesis of NPH.
- Early diagnosis and surgical management of spinal tumors can effectively treat associated NPH.