Taki Kowashi, Ninomiya Koshi, Yamamoto Akihiro, Suematsu Takuya, Sasaki Manabu, Kishima Haruhiko
Department of Neurosurgery, Osaka University Hospital, Suita, Japan.
Department of Neurosurgery, Hanwa Memorial Hospital, Osaka, Japan.
Surg Neurol Int. 2024 Jul 5;15:231. doi: 10.25259/SNI_129_2024. eCollection 2024.
Tumors in or near the foramen magnum may cause communicating or non-communicating hydrocephalus (HC), depending on their size and location. Here, an 81-year-old female developed communicating HC following the resection of a meningioma ventral to the foramen magnum.
An 81-year-old female presented with numbness in the left neck and left hemiparesis. The magnetic resonance revealed an 18-mm tumor ventral to the foramen magnum that significantly enlarged over the past 6 months. She underwent total tumor resection but then presented with progressive HC both clinically (i.e., instability of gait with confusion) and radiographically (computed tomography). Following placement of a lumboperitoneal (LP) shunt, symptoms markedly improved. Further, the cerebrospinal fluid (CSF) analysis showed elevated cell counts and protein concentrations, indicating likely "leakage" of intratumoral contents postoperatively contributing to the progressive HC.
Patients presenting with acute meningiomas ventral to the foramen magnum may develop postoperative communicating HC attributed to tumor-related CSF leakage of necrotic intratumoral components that can be successfully treated with a LP shunt.
枕骨大孔内或其附近的肿瘤可能会导致交通性或非交通性脑积水（HC），这取决于肿瘤的大小和位置。在此，一名81岁女性在切除枕骨大孔腹侧的脑膜瘤后出现了交通性脑积水。
一名81岁女性出现左颈部麻木和左侧偏瘫。磁共振成像显示枕骨大孔腹侧有一个18毫米的肿瘤，在过去6个月中显著增大。她接受了肿瘤全切手术，但随后在临床（即步态不稳伴意识模糊）和影像学（计算机断层扫描）上均出现了进行性脑积水。在置入腰大池-腹腔（LP）分流管后，症状明显改善。此外，脑脊液（CSF）分析显示细胞计数和蛋白质浓度升高，表明术后肿瘤内物质可能“渗漏”，导致了进行性脑积水。
枕骨大孔腹侧急性脑膜瘤患者术后可能会出现交通性脑积水，这归因于肿瘤坏死成分相关的脑脊液漏，可通过LP分流管成功治疗。
