Advertisement

Child's Nervous System

, Volume 33, Issue 2, pp 385–387 | Cite as

Tectal glioma presenting with clinical triad of obesity, amenorrhea and central cord syndrome with radiological pentad of hydrocephalus, empty sella, suprapineal diverticula, Chiari and syrinx

  • Sivashanmugam Dhandapani
  • Madhivanan Karthigeyan
  • Sushanta K Sahoo
  • Vivek Gupta
Case Report
  • 193 Downloads

Abstract

Background

Tectal gliomas (TG) are slow-growing tumors and generally present with features of increased intracranial pressure.

Case description

We describe an unusual case of a young girl who presented with clinical triad of obesity, primary amenorrhea and central cord syndrome. The radiology unveiled a pentad of hydrocephalus, empty sella, suprapineal recess diverticulum, secondary Chiari malformation and cervical syringomyelia, masking a relatively obscure tectal plate glioma. She was subjected to endoscopic third ventriculostomy (ETV). All of her symptoms improved after ETV and the tumor is being followed up. The possible pathogenesis of such a highly atypical clinico-radiological presentation is described.

Conclusion

This unusual syndromic presentation of tectal glioma without clinical features of increased intracranial pressure is probably due to increased compliance of third ventricular walls, and is relieved with ETV.

Keywords

Tectal glioma Hydrocephalus Empty sella Chiari Suprapineal recess diverticulum Syringomyelia Endoscopic third ventriculostomy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No funding was received for this research.

References

  1. 1.
    Dhandapani M, Gupta S, Dhandapani S, Kaur P, Samra K, Sharma K, Dolma K, Mohanty M, Singla N, Gupta SK (2015) Study of factors determining caregiver burden among primary caregivers of patients with intracranial tumors. Surg Neurol Int. 6:160Google Scholar
  2. 2.
    Dhandapani S, Srinivasan A (2016) Contiguous triple spinal dysraphism associated with Chiari malformation Type II and hydrocephalus: an embryological conundrum between the unified theory of Pang and the unified theory of McLone. J Neurosurg Pediatr. 17:103-6Google Scholar
  3. 3.
    Hayhurst C, Osman-Farah J, Das K, Mallucci C (2008) Initial management of hydrocephalus associated with Chiari malformation type I-syringomyelia complex via endoscopic third ventriculostomy: an outcome analysis. J Neurosurg 108:1211–1214Google Scholar
  4. 4.
    Tedeschi E, Rapanà A, Elefante A, De Liso M, Morrone R, Iaccarino C (2013) Expansion diverticulum of the suprapineal recess causing cerebellar ataxia. A case report. Neuroradiol J 26:163–167Google Scholar
  5. 5.
    Vega RA, Harrison JF, Scott GR (2014) Tectal plate glioma: lessons learned from a patient with hydrocephalus, Chiari malformation-1 and concomitant aqueductal stenosis. Clin Neurol Neurosurg 119:50–53CrossRefPubMedGoogle Scholar
  6. 6.
    Wu FZ, Fu JH, Chen JY, Lai PH (2010) Teaching neuroimages: acquired Chiari malformation with syringohydromyelia caused by posterior fossa tumor. Neurology 75:e59CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of NeurosurgeryPost-Graduate Institute of Medical Education & Research (PGIMER)ChandigarhIndia
  2. 2.Department of RadiologyPGIMERChandigarhIndia

Personalised recommendations