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Optic chiasm glioma, electrolyte abnormalities, nonobstructive hydrocephalus and ascites
A Shuper1, G Horev, S Michovitz
1National Center for Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
Medical and Pediatric Oncology
|July 1, 1997
Summary
A child with optic chiasm glioma developed ascites and unusual hypernatremia. High cerebrospinal fluid protein may explain these findings and hydrocephalus, suggesting specific OCG characteristics.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Neurosurgery
Background:
- Optic chiasm glioma (OCG) is a rare brain tumor affecting the optic pathways.
- Management often involves chemotherapy and surgical interventions like ventriculoperitoneal shunts.
Observation:
- A 4-year-old girl with OCG, hydrocephalus, and a shunt developed significant ascites.
- Ascitic fluid protein levels correlated with cerebrospinal fluid (CSF) protein levels.
- Marked hypernatremia (up to 190 mEq/l) occurred without altered mental status.
Findings:
- Chemotherapy influenced both CSF protein and ascites volume.
- High CSF protein likely impaired fluid absorption, causing hydrocephalus and ascites.
- Osmoreceptor dysfunction, possibly due to hypothalamic involvement and high CSF protein, may explain the hypernatremia and preserved mental status.
Implications:
- This case highlights potential unique clinical manifestations of OCG.
- Altered fluid dynamics and electrolyte balance warrant consideration in OCG management.
- Further chemotherapy trials are considered to manage ascites before shunt modification.