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Communicating hydrocephalus in treated leukemic patients.

J De Reuck, W De Coster, H vander Eecken

    European Neurology
    |January 1, 1979
    PubMed
    Summary

    Communicating hydrocephalus occurred in 7 leukemic patients due to leukemia cells blocking cerebrospinal fluid pathways. These areas, including arachnoidal villi, resist standard treatments, posing a challenge in managing leukemia brain complications.

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    Area of Science:

    • Neurology
    • Hematology
    • Oncology

    Background:

    • Leukemia can affect the central nervous system (CNS), leading to various complications.
    • Hydrocephalus, an accumulation of cerebrospinal fluid (CSF) in the brain, is a potential CNS complication.
    • Understanding the mechanisms of hydrocephalus in leukemia patients is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the occurrence and causes of communicating hydrocephalus in treated leukemic patients.
    • To determine the role of leukemic cell infiltration in CSF drainage pathways.
    • To assess the efficacy of current preventive treatments against leukemic cell invasion in specific brain structures.

    Main Methods:

    • Retrospective analysis of 124 necropsies from treated leukemic patients.
    • Examination of brain tissue for signs of hydrocephalus and leukemic cell infiltration.
    • Histopathological assessment of cerebrospinal fluid drainage structures, including arachnoidal villi and dural sinuses.

    Main Results:

    • Communicating hydrocephalus was observed in 7 out of 124 (5.6%) necropsies.
    • In 4 cases, hydrocephalus was attributed to leukemic cell obstruction of CSF drainage at arachnoidal villi and dural sinuses.
    • Leukemic cells were found to be resistant to destruction in these specific structures, despite preventive brain irradiation and intrathecal cytotoxic drugs.

    Conclusions:

    • Communicating hydrocephalus is a complication in a subset of treated leukemic patients.
    • Leukemic infiltration of arachnoidal villi and dural sinuses obstructs CSF outflow, causing hydrocephalus.
    • These specific anatomical structures present a sanctuary for leukemic cells, challenging standard preventive therapies.

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