title: Optic chiasm glioma associated with inappropriate secretion of antidiuretic hormone, cerebral ischemia, nonobstructive hydrocephalus and chronic ascites following ventriculoperitoneal shunting.
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.
authors.affiliation: Department of Pathology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee 53201.
authors.forename: T T
authors.initials: TT
authors.lastname: Tang
authors.forename: H T
authors.initials: HT
authors.lastname: Whelan
authors.forename: G A
authors.initials: GA
authors.lastname: Meyer
authors.forename: D R
authors.initials: DR
authors.lastname: Strother
authors.forename: E L
authors.initials: EL
authors.lastname: Blank
authors.forename: B M
authors.initials: BM
authors.lastname: Camitta
authors.forename: R A
authors.initials: RA
authors.lastname: Franciosi
mesh_terms: D001201:Ascites / Q000473:pathology* / Q000601:surgery*; D001254:Astrocytoma / Q000473:pathology* / Q000601:surgery*; D001706:Biopsy; D002557:Cerebrospinal Fluid Shunts; D003390:Cranial Nerve Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology* / Q000601:surgery*; D007177:Inappropriate ADH Syndrome / Q000473:pathology* / Q000601:surgery*; D007223:Infant; D009897:Optic Chiasm / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery; D012086:Reoperation