Optic chiasm glioma associated with inappropriate secretion of antidiuretic hormone, cerebral ischemia, nonobstructive hydrocephalus and chronic ascites following ventriculoperitoneal shunting.
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.
Tang
T T
TT
Department of Pathology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee 53201.
Whelan
H T
HT
Meyer
G A
GA
Strother
D R
DR
Blank
E L
EL
Camitta
B M
BM
Franciosi
R A
RA
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