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ISAMU Miura
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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| Article types | Case report |
| Language | English |
| Peer review | Peer reviewed |
| Title | Two cases of normal pressure hydrocephalus caused by ependymoma of the cauda equina. |
| Journal | Formal name：Surgical neurology international Abbreviation：Surg Neurol Int ISSN code：22295097/21527806 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 12,pp.8 |
| Author and coauthor | Miura Isamu†*, Kubota Motoo, Momozaki Nobuhiko, Yuzurihara Masahito |
| Authorship | Lead author |
| Publication date | 2021 |
| Summary | Background:Normal pressure hydrocephalus (NPH) associated with tumors of the cauda equina is rare. Here, we report two cases of NPH attributed to cauda equina ependymomas.Case Description:A 63-year-old male presented with progressive gait disturbance, dementia, and urinary incontinence. When the lumbar MR documented an intradural tumor involving the cauda equina at the L2-L3 level; the tumor was excised; pathologically, it proved to be a myxopapillary ependymoma. Postoperatively, however, the patient's continued gait disturbance led to a brain CT that documented ventricular dilation consistent with NPH; following ventriculoperitoneal (VP) shunt placement his symptoms improved. A 65-year-old female also presented with gait disturbance, dementia, and urinary retention. Here, procedures were performed in reverse. When a brain CT showed hydrocephalus, a VP shunt was placed. When symptoms persisted, a lumbar MR demonstrated a T12-L2 intradural tumor; following a lumbar laminectomy for tumor excision, symptoms stabilized. The pathological diagnosis was also consistent with a conus/cauda equina ependymoma. Over the next 10 years, the patient had residual bladder dysfunction (e.g., requiring straight catheterization), but had no shunt dysfunction.Conclusion:We observed two cases of ependymomas of the cauda equina and brain CTs documenting NPH that was successfully surgically managed with stabilization of neurological deficit. In the first case, L2-L3 laminectomy for tumor removal was succeeded by shunting for NPH, while in the second case, initial VP shunting for NPH was followed by a T12-L2 laminectomy for tumor excision. |
| DOI | 10.25259/SNI_851_2020 |
| PMID | 33500823 |