Normal pressure hydrocephalus associated with cauda equina neurinoma

Area of Science:

• Neurosurgery
• Neurology
• Cerebrospinal Fluid Dynamics

Background:

• Normal pressure hydrocephalus (NPH) is a neurological disorder characterized by gait disturbance, urinary incontinence, and cognitive impairment.
• Cauda equina neurinomas are rare tumors arising from the nerve roots of the cauda equina.
• Surgical intervention is a primary treatment for symptomatic neurinomas.

Observation:

• A 65-year-old female patient presented with symptoms consistent with normal pressure hydrocephalus.
• The patient underwent surgical resection of a cauda equina neurinoma.
• Post-operatively, significant improvement in gait and resolution of hydrocephalus were observed.

Findings:

• The presence of fibrinogen was detected in the patient's cerebrospinal fluid.
• Fibrinogen is a protein involved in blood clotting and may have implications in cerebrospinal fluid homeostasis.
• The successful surgical outcome suggests a potential link between the neurinoma and the hydrocephalus, possibly mediated by factors like fibrinogen.

Implications:

• This case highlights a potential, previously unrecognized association between cauda equina neurinomas and normal pressure hydrocephalus.
• Cerebrospinal fluid fibrinogen levels could be a novel biomarker or therapeutic target in understanding and managing NPH.
• Further research is warranted to elucidate the pathophysiological mechanisms linking neurinomas, fibrinogen, and NPH.