Abstract
An optic chiasm glioma may cause loss of vision, endocrine disturbances, hydrocephalus and cerebral ischemia due to its proximity to the pituitary, hypothalamus, III ventricle and internal carotids. A 3-month-old infant with optic chiasm glioma developed hypopituitarism and inappropriate secretion of antidiuretic hormone with plasma hypo-osmolality. The cerebrospinal fluid (CSF) protein concentration was markedly elevated. The impairment of fluid absorption via arachnoid villi and peritoneum by the high protein content, and reversed osmotic gradient between protein-rich CSF and hypo-osmolar plasma may have contributed to both nonobstructive hydrocephalus and recurrent ascites following ventriculoperitoneal shunting. Cerebral ischemia from carotid compression may have led to cerebral atrophy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adegbite AB, Khan M (1982) Role of protein content in CSF ascites following ventriculoperitoneal shunting. J Neurosurg 57:423–425
Borit A, Richardson EP Jr (1982) The biological and clinical behavior of pilocytic astrocytomas of the optic pathways. Brain 105:161–187
Buonaguidi R, Ferdeghini M, Leoncini R, Tusini G (1982) Hypothalamopituitary function in four cases of true precocious puberty. Child's Brain 9:211–221
Dean DF, Keller IB (1972) Cerebrospinal fluid ascites: a complication of a ventriculoperitoneal shunt. J Neurol Neurosurg Psychiatry 35:474–476
DeSousa AL, Kalsbeck JE, Mealey J Jr, Ellis FD, Muller J (1979) Optic chiasmatic glioma in children. Am J Ophthalmol 87:376–381
DiMattio J, Hochwald GM, Malhan C, Wald A (1975) Effects of changes in serum osmolarity on bulk flow of fluid into cerebral ventricles and on brain water content. Pflügers Arch 359:253–264
Fishman RA (1980) Cerebrospinal fluid in diseases of the nervous system. Saunders, Philadelphia, pp 188–189, 290–291
Goodman GM, Gourley GR (1988) Ascites complicating ventriculoperitoneal shunts. J Pediatr Gastroenterol 7:780–782
Gunnesson-Nordin V, Blennow G, Garwicz S (1982) Gliomas of the anterior visual pathway in children, tumour behavior and effect of treatment. Neuropediatrics 13:82–87
Hayakawa T, Morimoto K, Ushio Y, Mori T, Yoshimine T, Myoga A, Mogami H (1980) Levels of astroprotein (an astrocyte-specific cerebroprotein) in cerebrospinal fluid of patients with brain tumors: an attempt at immunochemical diagnosis of gliomas. J Neurosurg 52:229–233
Heisey SR, Held D, Pappenheimer JR (1962) Bulk flow and diffusion in the cerebrospinal fluid system of the goat. Am J Physiol 203:775–781
Helcl F, Petraskova H (1985) Gliomas of visual pathways and hypothalamus in children: a preliminary report. Acta Neurochir (Wien) 35 [Suppl]: 106–110
Hilal SK, Solomon GE, Gold AP, Carter S (1971) Primary cerebral arterial occlusive disease in children. II. Neurocutaneous syndromes. Radiology 99:83–87
Hirata Y, Matsukado Y, Mihara Y, Kochi M, Sonada H, Fukumura A (1985) Occlusion of the internal carotid artery after radiation therapy for the chiasmal lesion. Acta Neurochir (Wien) 74:141–147
Hochwald GM, Wald A, Malhan C (1976) The sink action of cerebrospinal fluid volume flow: effect on brain water content. Arch Neurol 33:339–344
Imes RK, Hoyt WF (1987) Childhood chiasmal gliomas: update on the fate of patients in the 1969 San Francisco study. Prog Exp Tumor Res 30:108–112
Iraci G, Gerosa M, Tomazzoli L, Pardatscher K, Fiore DL, Javicoli R, Secchi AG (1981) Gliomas of the optic nerve and chiasm: a clinical review. Child's Brain 8:326–349
Oelkers W (1989) Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism. N Engl J Med 321:492–496
Oster S (1987) Schwartz-Bartter's syndrome and mesencephalic astrocytoma. Clin Neuropathol 6:215–217
Prockop LD, Fishman RA (1968) Experimental pneumococcal meningitis: permeability changes influencing the concentration of sugars and macromolecular in cerebrospinal fluid. Arch Neurol 19:449–463
Rush JA, Younge BR, Cambell RJ, MacCarty CS (1982) Optic glioma: long-term follow-up of 85 histopathologically verified cases. Ophthalmology 89:1213–1219
Sklar C, Fertig A, David R (1985) Chronic syndrome of inappropriate secretion of antidiuretic hormone in childhood. Am J Dis Child 139:733–735
Sung DI (1982) Suprasellar tumors in children: a review of clinical manifestations and managements. Cancer 50:1420–1425
Thomsen J, Bech P, Nielsen OS (1978) CSF total protein: normal values—a reappraisal and discussion of its value in diagnosis of acoustic neuromas. Acta Otolaryngol (Stockh) 86:359–365
Verbalis JG (1986) Tumoral hyponatremia. Arch Intern Med 146:1686–1687
Weidmann MJ (1975) Ascites from a ventriculoperitoneal shunt. J Neurosurg 43:233–235
Wisoff JH, Abbott R, Epstein F (1990) Surgical management of exophytic chiasmatic-hypothalamic tumor of childhood. J Neurosurg 73:661–667
Yount RA, Glazier MC, Mealey J Jr, Kalsbeck JE (1984) Cerebrospinal fluid ascites complicating ventriculoperitoneal shunting: report of four cases. J Neurosurg 61:180–183
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tang, T.T., Whelan, H.T., Meyer, G.A. et al. Optic chiasm glioma associated with inappropriate secretion of antidiuretic hormone, cerebral ischemia, nonobstructive hydrocephalus and chronic ascites following ventriculoperitoneal shunting. Child's Nerv Syst 7, 458–461 (1991). https://doi.org/10.1007/BF00263189
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00263189